Dealer Application Business Name* Business Address* Address 2 City* State* Zipcode* Country* Phone*FaxWebsite Email* State Resale Number* Name Of Owner* Type Of Ownership* Date of Establishment* Your Name* First Last Position* Authorized PurchasersAuthorized Purchaser #1* First Last Authorized Purchaser #2 First Last Authorized Purchaser #3 First Last Trade References ( please include at least 2 )Ref #1Business Name* Contact Name* First Last Phone*FaxRef #2Business Name* Contact Name* First Last Phone*FaxRef #3Business Name Contact Name First Last PhoneFaxQuestionsDoes your office have an aftermarket retail store?* Yes No Is your company separate from the owners residence?* Yes No What are your business hours?*Does your office have a retail display area for your customers?* Yes No Required Documentation Please provide copies of:Voided Business CheckFileMax. file size: 512 MB.State Sales and Use Tax Permit (must be current)FileMax. file size: 512 MB.Business LicenseFileMax. file size: 512 MB.Please attach your documentation and submit - or - Fax to 972-690-0074 (attn Jevon) Email to info @ PickardUSA.com Download this form by clicking the link below Dealer-ApplicationCAPTCHANameThis field is for validation purposes and should be left unchanged.
