dealer application

ELITE WHEEL WAREHOUSE DEALER APPLICATION

Date Received:

Salesperson:

Customer #:

BUSINESS CONTACT INFORMATION

Legal Company Name:

DBA:

Phone:

Fax

E-mail:

Billing Address:

Shipping Address (if different from above):

Business License No:

Sales Tax Exemption No:

FEIN or SSN:

Accounts Payable Contact:

Phone/Ext:

Authorized Personnel to Charge Account:

E-mail:

BUSINESS AND CREDIT INFORMATION

Sole ProprietorshipPartnershipCorporationLLCOther
Sole Proprietorship Partnership Corporation LLC Other

Date Business Commenced:

Type of Business:

Date of Incorporation/Partnership/etc:

State:

PRINCIPALS OR OFFICERS:

Name:

Title:

Home Address:

Home Phone:

Driver’s License No:

SSN:

Has a bankruptcy ever been filed in your name?
YesNo
Are you qualified to do business in the state of Florida?
YesNo
Name:

Title:

Home Address:

Home Phone:

Driver’s License No:

SSN:

Has a bankruptcy ever been filed in your name?
YesNo
Are you qualified to do business in the state of Florida?
YesNo

BUSINESS/TRADE REFERENCES

Company Name

Account #

Contact

Phone

Address

Company Name

Account #

Contact

Phone

Address

Fax

Company Name
Account #

Contact

Phone

Address

BANK REFERENCES

Company Name

Account #

Contact

Phone

Address

Fax

RESALE CERTIFICATE

In compliance with SALES & USE TAX LAWS, it is necessary that we have the following information from all of our customers:

1. SIGNED Resale Certificate (see below), with State Sales Tax Permit Number to show merchandise purchased for resale;
[file-61 filetypes:gif|png|jpg|jpeg limit:2mb]
2. Copy of Sales/Use Tax or Exemption Certificate provided by State.
[file-62 filetypes:gif|png|jpg|jpeg limit:2mb]

Please complete the form below, including an authorized signature and address, and return with a copy of your State Resale/Exemption Certificate.
This certificate is invalid unless all four (4) sections are completed by the purchaser.
Your dealer application must include this signed certificate or your purchases will be charged sales tax

I. Check one of the following:
One-Time PurchaseBlanket Certificate*

One-Time Purchase Blanket Certificate*
The purchaser hereby claims exemption on the purchase of tangible personal property and selected services made under this certificate from Elite Wheel Warehouse and certifies that this claim is based upon the purchaser’s proposed use of
the items or services, or the status of the purchaser.

II. Items covered by this certificate
All items purchasedLimited to the following items:

III. Basis for exemption claim: Resale:
At Retail--- Sales Tax RegistrationNumber(Enter Below)
Non-Profit Organizations:
Government Entity, Nonprofit School, Nonprofit Hospital, Church (circle type of organization) InternalRevenue Code Section 501(c)(3) and 501(c)(4) OrganizationsExempt letter from State (please enclose copy)Other (explain):

IV. In the event this claim is disallowed, the purchase promises to reimburse the seller for the amount of tax involved.

Purchaser

Street Address

Phone

Signature


Title

Date

Name

TERMS & CONDITIONS:
Payment made to Seller must be made without discount in United States dollars pursuant to the terms set forth by agreement between Buyer and Seller. In the event Buyer does not pay amount due pursuant to the terms of this
agreement between Buyer and Seller. Buyer agrees to pay a delinquent interest charge of 1.5% per month pursuant to the laws of the State of Florida. Checks returned from the bank for insufficient funds or stop payments are subject to a fee of $30.00. Buyer agrees to immediately examine product upon receipt of delivery by Seller. Buyer agrees to advise Seller of any defective product within five (5) days of receipt. Buyer also agrees to examine all of Seller’s invoices and statements, and will advise Seller of any transaction disputes within ten (10) days of receipt in writing. Failure to notify Seller of any dispute or defective goods within the above timeframe shall constitute a complete waiver of any and all
such disputes. Buyer may only return product with prior authorization: all returns must be accompanied with an RMA number written on the outside of the container. Return authorization will only be given within thirty (30) days of
purchase. Returns are subject to a 20% restocking fee.

Seller may, at any time without notice, cancel all credit available to Buyer and refuse to make any further credit
advances. In the event Seller determines that information contained on this Dealer Application is false and misleading, or if Seller receives other false or misleading credit information from Buyer of any nature, Seller may without further notice cancel any orders in house, or any deliveries in progress to Buyer. Any false or misleading information by Buyer shall be construed as a material default and any invoices outstanding shall be immediately due and payable in full.
Applicant will notify Elite Wheel Warehouse in writing of any business changes in statue (i.e. new owner, becomes incorporated, loses a partner, changes banks, etc.).
AUTHORIZATION: I/We individually, as principal(s) or officer(s) of the company hereby authorize and request Elite Wheel Warehouse to consider my company’s application, and authorize my personal, credit reporting agencies,
company creditors and business references to provide information to Elite Wheel Warehouse Credit Department in conjunction with this application.
Title

Signature


Date

Name

Signature

Title

Name

Date

PERSONAL GUARANTTEE:

I/We, the undersigned and each of us , in consideration of any and all credit granted by Seller, guaranty prompt
payment when due of any and all indebtedness now due or which may hereafter become due from said entity to Seller.
This shall be a continuing guaranty and shall not be revocable, except upon actual receipt of Seller or written notice
that we, or any of us, revoke said guaranty as to transactions s become due from said entity to Seller. This shall be a
continuing guaranty and shall not be revocable, except upon actual receipt of Seller or written notice that we, or any of us, revoke said guaranty as to transactions subsequent to the date such notice is received and, in such event, I/we
shall continue to be responsible for any and all transactions which occurred prior to the date Seller actually received said notice. Guarantor agrees to be bound by each and all of the terms and conditions set forth in the Dealer
Application herein. The liability of the undersigned shall not be affected or prejudiced by the acceptance of a note or other indulgence granted to the applicant, or by any agreement affecting said indebtedness, and the undersigned
hereby waive notice of all aforesaid. The filing of a suit or exhaustion of legal remedies against the applicant shall not be a condition precedent to the enforcement of this guaranty, and the undersigned hereby expressly waives any prior notice of applicant’s default. GUARANTOR’S WAIVERS: Except as prohibited by applicable law, Guarantor waives any
right to require Seller: (a) to make any presentment, protest, demand or notice of any kind, including notice of any
nonpayment of the indebtedness or of any nonpayment related to any collateral, or notice of any action or non-action on the part of Buyer, Seller, any surety, endorser, or other guarantor in connection with the indebtedness or in
connection with the creation of new or additional sales; (b) to resort for payment or to proceed directly or at once against any person, including Buyer or any other guarantor; (c) to proceed directly against or exhaust any collateral
held by Seller from Buyer, any guarantor, or any other person; (d) to pursue any other remedy within Seller’s power.
GUARANTOR’S UNDERSTANDING WITH RESPECT TO WAIVERS: Guarantor warrants and agrees that each of the waivers set forth above is made with Guarantor’s full knowledge of its significance and consequences and that, under the
circumstances, the waivers are reasonable and not contrary to public policy or law. If any such waiver is determined to be contrary to any applicable law or public policy, such waiver shall be effective only to the extent permitted by law or public policy. The Seller will be reimbursed for reasonable attorney’s fees and cost of collection on any past due bill,
regardless of whether judicial action is undertaken. The Buyer agrees that jurisdiction and venue for any dispute under this contract are proper in Hillsborough County, State of Florida.

Guarantor

Date

Name

SSN

Guarantor

Date

Name

SSN



GET IN TOUCH:

Tel: (813) 673-8393

Email: sales@ewwfl.com

© 2019 Elite Wheel Warehouse. All Rights Reserved