Apex Dealer Application

Apex Dealer Application
Are you applying for Domestic or International Dealership?
Desired Dealership Level
Desired Dealership Level
Please list the wheels desired to satisfy buy-in:
What vehicles do you specialize in? (Select your 1-3 primary markets)

Other
Business Information
Business Name
DBA
Entity Type
State Corporation Filed In
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
Format: (000) 000-0000.
Email
Website
Start Year of Business
Federal EIN #
State Tax ID #
Business License #
Description Focus of business (select all that apply)
Principal / Owner / Office Information
#1 - Principal/Owner/Officer Name
Title
% of Ownership
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
Format: (000) 000-0000.
Email
#2 - Principal/Owner/Officer Name
Title
% of Ownership
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
Format: (000) 000-0000.
Email
Accounts Payable
A / P Contact Name
A / P Phone Number
Format: (000) 000-0000.
A / P Email
Additional Authorized Contacts / Purchasers
#1 Authorized Contact Name
#1 Authorized Contact Phone Number
Format: (000) 000-0000.
#1 Authorized Contact Email
#2 Authorized Contact Name
#2 Authorized Contact Phone Number
Format: (000) 000-0000.
#2 Authorized Contact Email
Attach a copy of valid Business License

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Attach a recent interior photo of your business

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Please verify that you are human
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Apex Dealer Application

Business Information

Principal / Owner / Office Information

Accounts Payable

Additional Authorized Contacts / Purchasers