Dealer Application

Please fill out the following Dealer Application form. For security reasons, please call or fax us your credit card info.


General Company Information




Contact Information




Organization Information
Proprietorship
Partnership
Corporation
LLC



ReferencesPlease list names and phone numbers of three Trade References (Parts or Tucker or WPS accounts if available):


Supporting DocumentsPlease fax the following documents to us at 678 534 5793:
  • Proof of Business - Copies of your Federal Tax ID, Business License, State Tax ID or Sellers Permit
  • Photocopies of advertising or business cards.
  • Proof of location - Photos of your retail shop or kiosk
The more supporting documentation you provide, the faster we can process your dealer application.