Dealer Application

PLEASE FAX COMPLETED APPLICATION AND APPLICABLE DOCUMENTS TO 888.228.3674
DEALER APPLICATION
Radial Sports LLC Dealer Application Page 1/1
Business Name____________________________________________________________________________ Phone #______________________________
Name of Owner/Principal______________________________________________________________________ Fax # ________________________________
List legal corporate name if not the same as above_______________________________________________________________________________
Billing Address___________________________________________________________
City______________________________ State ______ Zip _______
Shipping Address _________________________________________________________ City______________________________ State ______ Zip _______
Website Name: ________________________________________________________ E-mail Address: ___________________________________________
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Principal Owner(s):
Full Name________________________________________________________________________
Title_____________________________
Home Address________________________________________________________ City______________________ State_______ Zip________
Home Tel #____________________________ Cell Phone # _______________________ Social Security #___________________ Birth Date_______________
Full Name _______________________________________________________________________
Title________________________________
Home Address_______________________________________________________ City _______________________ State ______
Zip________
Home Tel # ___________________________ Cell Phone # ________________________ Social Security # ___________________ Birth Date______________
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Type of Ownership:
( ) Sole Proprietorship
( ) Partnership
( ) Corporation
( ) INC
Years under present management___________________
Date Business Started_______________________________
Federal I.D. # _____________________________________
State Resale #____________________________________________
If Corporation: State of incorporation_________________
Date incorporated________________________________
Store Square Footage________________
#Employees__________
Last year’s total sales $____________________________
Business space: Rent ( ) or Own ( ) Landlord’s/Mortgagor’s Name_____________________ _________________________________________
Landlord/Mortgagor’s address _______________________________________________ City_______________ State____ Zip_________ Ph # ____________
Use inventory to borrow from your bank? ( ) Yes ( ) No
if yes: Name of Bank _______________________________________________________
Address ______________________________________________ City_____________________ State______ Zip ________Phone #_______________
Have you ever filed bankruptcy? ( ) YES
( ) NO
If yes, when____________________________________
---------------------------------------------------------------------------------------------------------AGREEMENT: As an owner/officer of my company, and an applicant applying for credit or other business transactions, I certify that the information provided in this
application is correct and agree to make payments in full for all valid purchases. By signing and submitting this credit application, I hereby grant Radial Sports LLC
(a California Limited Liability Company) a Purchase Money Security Interest in all of its current and future inventory, including without limitation all of its inventory
of products purchased from Radial Sports LLC and all proceeds of the same and further grant Radial Sports LLC limited power of attorney to execute one or more
financing statements, amendments, continuations and termination statements pursuant to the Uniform Commercial Code of the state in which retailer is conducting
business, satisfactory to Radial Sports LLC. This power of attorney is limited solely to the powers stated herein. Financial statements may also be required. By
signing below, and in consideration for the credit extended me by Radial Sports LLC the undersigned hereby agrees to the following terms and conditions: We
agree to pay all invoices rendered by Radial Sports LLC within 30 days from invoice date, unless other arrangements have been made in writing to the dealer by
Radial Sports LLC. If we fail to pay by the due date, we agree to pay an interest rate of 1.5% per month (or maximum allowed by law) calculated on a simple basis
on the amount of the invoice. If Radial Sports LLC is required to take legal action to enforce payment, we agree to pay costs including reasonable attorney’s fees
and collection costs, or, at the option of Radial Sports LLC a specific sum equal to 10% of the total amount due, provided that this provision of attorney’s fees and
collection costs is void where prohibited by applicable laws. The undersigned certifies that he/she is authorized to execute this document and that all statements
are true and correct. Verification may be obtained from any source named in this application. I/we authorize my/our creditor(s) and financial institution(s) such
information as Radial Sports LLC shall request for the purpose of verification of any information or statements contained in this application and that a copy of this
authorization may be used to obtain such information. I/we hereby authorize Radial Sports LLC to provide information contained herein to other credit reporting
services and suppliers. If the credit customer is a corporation, partnership, or incorporated, then those signing this application, whether signing as an officer or not,
personally guarantee payment for all products purchased on credit by the corporation, partnership, or INC. See Personal Guarantee on page 2 for full details. I/We
hereby agree to comply with the terms of this agreement and all applicable laws.
COPY OF YOUR CURRENT RESALE TAX CERTIFICATE REQUIRED.
Signature of Applicant __________________________________________________________Title_____________________
Date________________
Signature of Co-Applicant________________________________________________________Title_____________________
Date ________________
2675 Skypark Dr, Ste 205 | Torrance CA 90505 | 888.228.3674 | [email protected] | radialsports.com | ffwdusa.com
PLEASE FAX COMPLETED APPLICATION AND APPLICABLE DOCUMENTS TO 888.228.3674
CREDIT CARD AUTHORIZATION FORM
Radial Sports LLC Credit Card Authorization Form Page 1/1
Account # (If applicable): _________________________________________________
Company name: ___________________________________________________________
Address: _________________________________________________________________
City: _____________________________________ State: _____ Zip Code: ____________
Phone Number: _________________________________________________
Fax Number: ___________________________________________________
CREDIT CARD BILLING ADDRESS (IF DIFFERENT FROM ABOVE)
Company name: ___________________________________________________________
Address: _________________________________________________________________
City: _____________________________________ State: _____ Zip Code: ____________
Phone Number: __________________________________
Cardholder’s Name (Please Print): ____________________________________________
Cardholder’s Signature: _____________________________________________________
Credit Card Number: ________________________________ Exp. Date: ______________
Secondary or Alt CC #: ________________________________ Exp. Date: _____________
Driver License # / State: _____________________________________________________
Please Check One:
VISA
MASTERCARD
AMEX
DISCOVER
*Card Verification Value (CVV): ____________
Please List additional authorized users:
______________________________________________________________________
*- For Visa/MC, this is the last three digits of the long number on the back of the card.
*- For American Express cards, this is four digits number on the front of the card.
Note: Please provide a copy of both front and back of card to be used and attach it
to this form. Signature on back of the card must match signature on this form.
OFFICE USE ONLY
Last Updated:
__________________
__________________
__________________
__________________
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2675 Skypark Dr, Ste 205 | Torrance CA 90505 | 888.228.3674 | [email protected] | radialsports.com | ffwdusa.com