Become A Dealer - Factory Reproductions

Legal Full Name of Applicant

First

Last

Name of Company

SSN/TIN/EIN

Business Structure

Business Legal Address (No PO Boxes)

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country / Postal Code

Telephone

Email

Trade Name/DBA Used (if any)

Years in Business

Business Shipping Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country / Postal Code

Website

Business Structure

Profile URLs

How many wheels do you sell a month?

Who do you currently purchase your wheels from?

How do you sell your wheels

Buyer Contact Name

First

Last

Buyer Direct Phone

Buyer Direct Email

Accounting Contact Name

First

Last

Accounting Direct Phone

Accounting Direct Email

Customer Service Contact Name

First

Last

Customer Service Direct Phone

Customer Service Direct Email

Marketing Contact Name

First

Last

Marketing Direct Phone

Marketing Direct Email

Business License or Sellers Permit (copies needed)

Max. file size: 512 MB.

Signed Resale Certificate (Excluded States: Alaska, Delaware, Montana, New Hampshire, and Oregon) (copies needed otherwise):

Max. file size: 512 MB.

Don't have this yet?
Download a blank resale certificate here fill it out, then upload it.

Privacy and Security Policy Consent

I Accept and Agree to the Privacy and Security Policy.

Read the Privacy Policy Here

MAP Policy Consent

I Accept and Agree to the MAP policy.

Read the MAP Policy Here

Email Consent

By checking this box, I agree to receive electronic communications from Factory Reproductions related to my account, including updates, changes, and important notices.

RETYPE FIRST AND LAST NAME AS DIGITAL SIGNATURE

First

Last

Title

Company

Date