T Mobile Dealer Sign up Form

Dealer Sign up Form
Business Federal Tax classification*
Business Legal Name*
Tax Filer Name

First NameLast Name
DBA Name
Filled DBA
Sub-Dealer Candidate Business Name
Federal Employer Identification Number (EIN)
Business Legal Registered Address*

Street Address

Street Address Line 2

CityState

Zip Code
Is your Business Legal Address Same as your Residential Address*

YesNo
Is your Business Legal Address Same as your Business Physical Address*

YesNo
Business Physical Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Sales Tax Permit State*
Sales Tax Permit Number *
Upload Sales Tax Permit*

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Business Owners Name *

First NameLast Name
Date of Birth*

MonthDayYear
Date
Residential Address*

Street Address

Street Address Line 2

CityState

Zip Code
Social Security Number*
T-Mobile Request one of the Business owner's SSN
Driver License

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All information collected above will be used by us to submit for dealer creation with selected carriers on behalf of you.by signing below you agree to this terms.
Signature*
Should be Empty: