Clone Dealer Application


Company Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Website:
Email Address:
Federal Tax ID#
Resale Tax#
Owner:
Year Established:
Please list one Trade References, their address and phone:
Best time to contact you:
Agree with the terms listed below: YES
NO

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Terms:

I agree that the information above is correct and if any check written by this company should be rejected by the bank, our company will be responsible for the amount of the check and a service charge of $20.00. All payments are to be made within 5 calendar days of notification if check is returned by the bank.

Stout Racing Engines reserves the right to decline/cease doing business with anyone who does not meet the following qualifications and/or does not represent Stout Racing Engines in the most favorable way possible. The business must be a kart racing, motor building, or related business with all appropriate state/county/city business licenses, operating on a full or part-time time basis in an established permanent location. Stout Racing Engines reserves the right to review approved dealers at any time and to modify or terminate the business relationship. By applying for approved status as an official Stout Racing Engines parts dealer, businesses accept all the above terms and agree that Stout Racing Engines shall not be held liable for any monetary concerns of any kind should the relationship end for any reason whatsoever.


COMPLETION OF THIS APPLICATION DOES NOT GUARANTEE DEALER APPROVAL

Contact: Lewis Stout

(423) 584-6663

Email: gummy07@charter.net