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HOME // NEW DEALER INQUIRY // DEALER APPLICATION Type of Business (required) Sole Proprietorship Partnership Corporation LLC Structure of Business (required) Retailer Mail Order Distributor/Wholesaler (No Retail Store) Distributor/Wholesaler (With Retail Store) Internet Retailer Majority customer (required) JDM car European car Domestic car Other Full Legal Name (required) First Mid Last Title (required) Owner President Vice President General Manager Manager Sales Rep Other Address (required) city State Zip Phone (required) FAX (required) E-mail Address SSN# Driver's License# (required) State LeqalBusiness Name (required) DBA Month / Year Started Address (required) city State Zip Mailing Address (if difference) city State Zip Phone (required) FAX (required) Contact Person E-mail Address (required) Federal Tax ID# (required) CA Resale# Number of Employees Company's Credit Card# Expiration Date Length of Ownership (required) 1 year 2 year 3 year 4 year 5 year 6 year 7 year 8 year 9 year over 10 years Prior Bankruptcy (required) YES NO Checking Account# Bank Name Bank Address city State Zip Phone (required) FAX (required) Average Balance Equity Line Credit Line

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