Sub-Dealer Candidate Information For Company Pre-Approval
Carrier Sign Up List (Subject to Carrier Approval)
*
T-Mobile
Ultra Mobile
Paymaster Portal
Epay
Sub-Dealer Business Name
*
DBA (If Any)
Sub-Dealer First and Last Name
*
Sub-Dealer Title
*
Email
*
example@example.com
Date of Birth
*
Social Security Number (Must Enter SSN. Application will not be processed without it)
*
Federal Tax ID Number
*
Sales Tax Number (if different from above)
Business Tax Classification
*
Individual/Sole Proprietor
Single Member LLC
C Corp
S Corp
Limited Liability Company
Partnership
Trust/Estate
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business State of Formation
*
How many locations do you own?
1 Location
2 Locations
3 Locations
4+ Locations
Type of Business
*
Market (within the area)
Target Customers
Years in Business
Work Phone
*
Mobile/Home Phone
*
Bank Name i.e (Chase,BOA)
*
Bank Address
*
Bank Routing Number
*
Bank Account Number
*
Identification (i.e License, Passport, Permit, State ID)
*
Browse Files
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Voided Check
*
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of
Articles of Incorporation/Formation
*
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of
Business License/Tax Exemption Certificate
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of
Today's Date
*
-
Month
-
Day
Year
Date
Signature
*
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