SHAVER OUTDOOR
WOOD FURNACES
Dealer Application
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Weld Rite Inc.
328 Hwy 62 West
Salem, Arkansas 72576
870-895-3104 |
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We must receive
all of the following from your company to
Qualify for Dealer pricing:
1) A completed Dealer Application.
2) Copy of business or resale license.
3) Arkansas dealers must fill out Resale Tax Form and fax current
copy of tax permit.
4) A photograph of your business faxed or e-mailed to us.
5) A copy of your yellow pages ad or copy of a business card. |
Payment Terms:
Weld Rite Inc. does not offer open account terms.
Payments must be made via: Credit Card (3% surcharge); Wire
Transfer; Cashier Check; or Money Order before delivery. |
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| SHAVER
Dealer Application |
GENERAL INFORMATION
Business Trade Name (DBA)
Business Legal Name (as it appears on business license)
Complete
Business Street Address (Street, City, State and Zip
Code)
Business Phone
FAX Number
Billing Address (if different (Street, City, State and
Zip Code)
Shipping Address (if different - Street, City, State and Zip Code)
Officer/Owner Name Title
Officer/Owner Name Title
DESCRIPTION OF BUSINESS
This company is a (Check one)
Sole Proprietorship
Partnership
Corporation
Are You a franchise dealer for a major
manufacturer (any business)?
If so, what manufacturers
Incorporated in the State
of
Length of time operating under the above
name:
Length of time at the above address:
Number of Branches/outlets operated/managed
by you:
Website Address
E-Mail Address
INDUSTRY REFERENCES
(Must be suppliers that are actively distributing related
industry parts to your business in the past 12 months; preferably in
the U.S.A.- any industry))
Business Name, Address, City, State, Zip
Phone
#
Fax
#
Account
#
Business Name, Address, City, State, Zip
Phone
#
Fax
#
Account
#
Business Name, Address, City, State, Zip
Phone
# Fax
#
Account
#
TAX EXEMPTION INFORMATION
(ARKANSAS
DEALERS ONLY)
COPY OF CERTIFICATE MUST BE
FAXED TO (870) 895-3111
Exemption Claimed (MUST select
one)
Resale
Federal Government
Exempt Organization
State and Local Government
Other
Product or Service Rendered:
General Description of products to be purchased
by the seller:
Certificate ID Number:
Name and Title of Applicant:
© COPYRIGHT 2006, 2007, 2008
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