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Dealer Application
Step
1
of
2
50%
Dealer Information
Business Information
Legal Business Name
Date
DBA
(If Different)
Address
City
State
Zip
Website
Annual Sales Estimate
Organization Type
Sole Proprietorship
Partnership
Corporation
LLC
Date Business Commenced
Principal Owner(s)
Address
City
State
Zip
Phone
Powersports Brands Represented
Purchasing
Authorized Purchasers
Phone
Fax
Email
Physical Address
City
State
Zip
POs Required
Yes
No
Billing
Accounts Payable Contact
Phone
Fax
Email
Billing Address
City
State
Zip
Preferred Invoice Delivery
Mail
Email
Fax
Are Purchases Tax Exempt?
Yes
No
If Tax Exempt, a copy of your State Resale Certificate must be attached.
State Resale Certificate
Max. file size: 512 MB.
Tax Resale No
Finalizing
Consent
I/we hereby wish to apply to become an Eagle MTX Dealer. I/we have read the Terms and Conditions of Sale and hereby agree to abide by them:
Name of Dealership
Name
Date
MM slash DD slash YYYY
Signature
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Dealer Credit Application
Business Information
Legal Business Name
Date
DBA
(If Different)
Address
City
State
Zip
Website
Annual Sales Estimate
Organization Type
Sole Proprietorship
Partnership
Corporation
LLC
Date Business Commenced
Principal Owner(s)
Address
City
State
Zip
Phone
Trade References
Reference One
Trade Reference
Phone
Fax
Address
City
State
Zip
Reference Two
Trade Reference
Phone
Fax
Address
City
State
Zip
Reference Three
Trade Reference
Phone
Fax
Address
City
State
Zip
Finalizing
Consent
I understand that the information furnished in this Application is for the purpose of obtaining credit with Eagle Mountain Outfitters, LLC and that I am authorized to apply for credit. I authorize Eagle Mountain Outfitters, LLC, its employees, or any credit bureau employed by the Company to investigate any references herein listed or data obtained from me or any other person or firm pertaining to our credit, financial and personal responsibility.
Consent
By my signature, I understand, and agree to comply with, all Terms and Conditions as provided.
Customer
Name
Title
Date
MM slash DD slash YYYY
Signature
Reset signature
Signature locked. Reset to sign again
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