Parts Department Wholesale Application Form

Company Name: required

Address: required

City: required

State: required

ZIP Code: required

Phone Number: required

Length of time in Business: required

Owner: required

Bank Name: required

Point of Contact: required

Number of Years doing Business with Bank: required

Phone Number: required

Date Business Began: required

Type of Business: Corporation Partnership Sole Proprietorship

Federal ID # or SSN# if Sole Prop.

Type of Charge Acct: Collision Mechanical

Credit Amount Requested:

Oklahoma law.

Oklahoma Tax Commission, Sales Tax Division

Blanket Certificate of Resale

This is to certify that all material, merchandise, or goods purchased by the undersigned from

Jim Norton Toyota of OKC is purchased for the following purpose: Resale as tangible personal property
To be incorporated as a material or part of other tangible personal property to be produced for sale be manufacturing, assembling, processing or refining
To be exported for sale,use, or consumption outside the continental limits of the United States.
Other

This certificate shall be considered a part of each order which we shall give provided such order.

Contains our certificate number. This certificate is to continue in force until revoked.

Certificate Number:

by:

If granted credit, I agree to pay all bills on the 10th of the month following purchase All outstanding accounts at 2nd billing cycle are subject to 1.5% svc chg. At 3rd billing cycle, acct is charged additional 5% and same for every billing cycle thereafter until acct is paid in full.

Signed:

Position:

Business Manager:

Phone:

Date:

E-mail Address:

TO BE COMPLETED BY APPLICANT

1. Business References: required

Address: required

City: required

Phone Number: required

2. Business References: required

Address: required

City: required

Phone Number: required

3. Business References: required

Address: required

City: required

Phone Number: required

4. Business References: required

Address: required

City: required

Phone Number: required

5. Business References: required

Address: required

City: required

Phone Number: required