Dealer Application
Aerotech Styling Inc.
14181 County Road 10-2
Lyons, Ohio 43533
Fax: 419-923-6970
DATE: _______________________
PHONE: ______________________
FAX: _________________________
CONTACT NAME __________________________________________
COMPANY
NAME _________________________________________
BILLING ADDRESS ________________________________________
CITY______________________ STATE_______
ZIP_______ -_____
SHIPPING ADDRESS_______________________________________
CITY______________________ STATE_______
ZIP_______-_____
BUSINESS OWNER ________________________________________
ADDRESS_________________________________________________
CITY______________________ STATE_______
ZIP_______-_____
COMPANY/CORPORATION MUST BE IN THE BUSINESS OF RESELLING OR INSTALLING RACING EQUIPMENT
I
(WE) THE UNDERSIGNED HEREBY PERSONALLY GUARANTEE PAYMENT OF ANY DEBT INCURRED
BY THE ABOVE-NAMED COMPANY OR CORPORATION TO AEROTECH STYLING INC.
SIGNATURE________________________________________________________
PLEASE PROVIDE A COPY OF ANY 2 (TWO) OF THE FOLLOWING
DOCUMENTS ALONG WITH YOUR APPLICATION:
FEDERAL ID (FEIN) #, STATE LICENSE, VENDORS LICENSE, COMPANY
LETTERHEAD, COPY OF ADVERTISEMENT