Dealer Application for a Business Account

Please fill out the following application. You will be able to create an account once your application is approved.

Contact Information

Title

Company Name

Phone

Fax

Registered Company Address

City

Region

Postal code

Country

Date Business Commenced

Ownership type

Business and Credit Information

Primary Business Address

City

Region

Postal code

Country

How long at current address?

Phone

Fax

E-Mail

Bank Name

Bank Address

City

Region

Postal code

Country

Phone

Type of Account

Reference #1

Company Name

Address

City

State

Zip

Phone

Fax

Type of Account

Reference #2

Company Name

Address

City

State

Zip

Phone

Fax

Type of Account

Reference #3

Company Name

Address

City

State

Zip

Phone

Fax

Type of Account

By submitting this application and clicking this checkbox, I agree to the following:

All invoices are PAID by Credit Card, Check or Cash with each order unless other arrangements are approved prior to your order.
Claims arising from invoices must be made within seven working days of shipment.
By submitting this application, you authorize TackleTech to make inquiries into the banking and business/trade references that you have supplied.