Synthetic Turf Brokers Dealer Application

To become a STB dealer and access our special prices you will need : order 1500 sq/ feet of turf and have valid business license. We work individually with every dealer to bring you the lowest prices possible. Please fill out an application to get the best deal in synthetic turf

DEALER APPLICATION SYNTHETIC TURF BROKERS

Company Name:
Mailing Address:
City: State: Zip Code:
Phone NO: Fax NO:
Email Address:
Website:
Shipping Address (If other than Mailing):
City: State: Zip Code:
Phone NO: Fax NO:
Business Type: Proprietorship Incorporated Partnership
In business since: Present Owner Since:
Federal I.D.# State Resale #
Owned By:
Accounts Payable contact: Phone NO:
Primary contact: Phone NO:
Technical Support Contact: Phone NO:
Owner’s Home Address:
City: State: Zip Code: Home Phone NO:

Credit References

	Name & Address	Phone NO	Fax NO
1
2
3

Credit References
Bank Name: City: State:
Phone NO: Fax NO:
Account #: Checking Saving
Store Credit Card # Name on card:
Exp. Date: Credit Card mailing addressee Street# Zip Code:

You are hereby authorized to release information on all our accounts maintained at our bank to SYNTHETIC TURF BROKERS including average balance, activity, and NSF history.

You are hereby authorized to charge on our credit card for the balance on our account over 60 days from invoice due date and mail either our account statement or invoices with credit card receipt to us.

The information given in this application is complete and accurate, and authorizes SYNTHETIC TURF BROKERS to check with credit reporting agencies, credit references, banks, and other sources disclosed herein in investigating the information given.

DATE: Authorized Signature: Authorized Print Name: