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Email *
Phone Number *
Business Name (include DBA) *
Number of Locations *
Business Address (please list all) *
Number of Years in Business *
Number of Years Experience *
If Yes, Please Explain the Business.
Current Insurance Company (Current Dealers Only)
Current Insurance License # (Current Dealers Only)
Current Insurance Expiration Date (Current Dealers Only)
If Yes, Who And What Tickets, Accidents, Or Violations?
How Many Dealer Tags Do You Have or Plan on Getting? *
How many Transporter Tags Do You Have or Plan on Getting? *
Where Are Keys to Vehicles Kept? *
Percentage (%) of Normal Automobiles You Sell (of all Sales)? *
Percentage (%) of Commercial Trucks You Sell (of all Sales)? *
Percentage (%) of Rebuilds You Sell (of all Sales)? *
Percentage (%) of Antiques/Classics You Sell (of all Sales)? *
Percentage (%) of Boats You Sell (of all Sales)? *
Percentage (%) of RV’s You Sell (of all Sales)? *
Percentage (%) of Motorcycles You Sell (of all Sales)? *
Maximum Wholesale Cost of A Vehicle You Will Purchase?
Maximum # of Vehicle Owned at Any One Time?
% of Retail Sales? *
% of Wholesale Sales? *
% of Consignment Sales? *
% of Exporting Sales? *
If You Sell on Consignment, What Is the Maximum Value of Any One Vehicle $____, and the Maximum # of Autos?
Physical Damage Coverage you Need? (Should Equal At Least The # Of Vehicles Times the Average Cost Per Auto) *
If Landlord Needs to be Listed, Please Enter Landlords Full Name
If Landlord Needs to be Listed, Enter the Square Footage of Building
If Landlord Needs to be Listed, Enter the Limit of Coverage Landlord is Requesting
If You Use Floor Planning, Whom Do You Use?
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