DEALER APPLICATION Please fill out the form below to apply online. Leave this field blank Business Information Legal Business NameRequired Mailing AddressRequired Shipping AddressRequired CityRequired Province / StateRequired Postal Code / ZIP CodeRequired Phone #Required Fax # GST #Only required for Canadian Customers. PST #Only required for Canadian Customers. Fed. ID# or SSN (customs requirement)Only required for US Customers. Courier Account # Purchasing / Sales ContactRequired Accounts Payable ContactRequired Credit References - List 3 Major Suppliers Supplier 1 NameRequired Address & EmailRequired Phone #Required Fax #Required Supplier 2 NameRequired Address & EmailRequired Phone #Required Fax #Required Supplier 3 NameRequired Address & EmailRequired Phone #Required Fax #Required Bank Reference NameRequired AddressRequired Phone #Required Fax #Required Authorization Applicants Signature Attests financial responsibility, ability and willingness to pay our invoices in accordance with the following terms. Terms for payment of invoices are Net 30 days from invoice date. Accounts not paid within terms will be charged interest invoiced at 2% per month, 24% per annum. Customer will be responsible for paying collection costs including legal fees (if applicable) in the event of delinquency in payment of account. It is fully understood that all products purchased from TerraCab Industries remain the sole property of TerraCab Industries until such time payment, including all interest charges, are paid in full. Overdue accounts may be subject to orders being held until the account is in current status. Purchase orders for non-standard products are subject to the same terms and conditions as applied to invoices. It is fully understood that product claims (i.e. warranty, shipping, etc.) are dealt with independently, and will not affect full payment of invoices at regular terms. It is fully understood that TerraCab does not guarantee fit of product when mounted in conjunction with attachments, or non-standard equipment, not pre-approved by TerraCab Industries, and resulting claims will not affect full payment of invoices at regular terms. It is fully understood late of non-payment by end-users (i.e. individuals, institutions, government bodies, etc.) will not affect full payment of invoices at regular terms. Your NameRequired Your PositionRequired AuthorizeRequiredThe above information is for purposes of obtaining credit and is warranted to be true. I/we hereby authorize the company to whom this application is made to investigate the references listed pertaining my/our credit and financial responsibilities.