Dealer Application (English)

Auto Group Dealer Application Form


Company Information
Business Legal Structure

Business Address (Billing)
Shipping Address (If Different)
Tax Exemption

Account Information

Bank Reference
Name of Bank Transit # Account # Bank Address Contact Name Action
Trade References (Minimum 3 Required)

I/We hereby request a revolving credit account from Auto Country and agree to pay for all invoices charged to the account.

All invoices are subject to interest charges for late payment of 2% per annum (2% per month).

A restocking fee of 15% will be charged on all items returned.

Auto Country reserves the right to revoke, suspend or terminate the credit account at its discretion.

Annual financial statements may be requested on all accounts with credit lines.

The undersigned certifies that all information submitted is true and correct and also gives consent to obtain information from all sources listed including 3rd party credit reporting agencies on both a personal and corporate level and further agrees to all terms and conditions listed above.

or drag files here.