Become a Registered Dealer

Must be signed by an owner, partner, principal officer or designated signee

If you are attaching your own company application form, it must also be signed for collection agreement.

I am authorized to complete this application and certify the above information is true and complete to the best of my knowledge.

I authorize our bank and vendor to release information needed for the purpose of establishing credit worthiness. It is agreed that if credit is granted, the method of payment will be met according to the terms on the invoices.

Reference 1

Reference 2

*Add your current tire supplier reference