Epsilon and Reserve Dealer Agreement

Epsilon Direct Dealer Agreement

Digital Authorized Dealer & Reserve Agreement
Today's Date*

MonthDayYear
Date
This Agreement is made between Epsilon Electronics, Inc., a California Corporation, 1550 S. Maple Ave., Montebello, CA, 90640 (hereinafter, “EPSILON ELECTRONICS, INC.”) and dealer as stated below.
Store/Dealer Name*
Legal Business Name/DBA (If Different)
Contact*

First NameLast Name
Store Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Fax Number
Please enter a valid phone number.
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Shipping Address (If Different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Retail Outlet*

This address IS a retail outletThis address IS NOT a retail outlet
Website URL
Social Media
Instagram, Facebook handle
Store/Dealer Name*
Contact*

First NameLast Name
Type of Business*

Sole ProprietorPartnershipLLCCorporation
Signature*

Clear
Should be Empty:

Epsilon Direct Dealer Agreement