Become A Dealer

Name of Company:

SSN/TIN/EIN:

Business Contact Name:

Telephone:

Email:

Trade Name/DBA Used (if any):

Years in Business:

Website:

How many wheels do you sell a month?

Who do you currently purchase your wheels from?

How do you sell your wheels?

Buyer Direct Phone:

Buyer Direct Email:

Accounting Direct Phone:

Accounting Direct Email:

Customer Service Phone:

Customer Service Email:

Marketing Contact Phone:

Marketing Contact Email:

Business License or Sellers Permit (copies needed):(Required)

Max. file size: 512 MB.

Signed Resale Certificate (required if located in CA) (copies needed):

Max. file size: 512 MB.

Title:(Required)

Company:(Required)

Date(Required)

CAPTCHA

To apply using a paper form, download the application and send to [email protected]