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We must receive ALL of the following from your company to
Qualify for Dealer pricing:
1) A completed Parts Dealer Application.
2) Copy of business or resale license.
3) Florida 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:
RIVA Racing does not offer opent account terms.
Payments must be made via: Credit Card; Wire
Transfer; Company Check; Cashier Check; or Money Order. |
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| PARTS Dealer Application |
GENERAL INFORMATION
Business Trade Name (DBA)
Business Legal Name (as it appears on business license)
Business Street Address (Street, City, State and Zip
Code)
Business Phone
FAX Number email
address
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?
If so, what manufacturers
-Yamaha
-Honda
-Kawasaki
-Sea-Doo
-Polaris
-Other
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:
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.)
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
#
PERSONAL CREDIT INFORMATION (Owner / Partnership)
Name Credit
Card #
Credit
Card Payment is accepted for U.S. Dealers ONLY.
Home Address Name
on credit card
City, State, Zip Billing
Address on credit card
Telephone Number Telephone
Number
Social Security Number
Drivers License Number
Have you ever filed bankruptcy? Yes
No
Personal
Date Filed:
Current Status:
Business
Date Filed:
Current Status:
BANK INFORMATION
TAX EXEMPTION INFORMATION (FLORIDA
DEALERS ONLY)
COPY OF CERTIFICATE MUST BE
FAXED TO (954) 785-2535
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:
COPY OF CERTIFICATE MUST BE FAXED TO (954) 785-2535
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