King Shocks Clothing - Dealer Inquiries

Thanks for your interest in King Shocks Factory Racing Gear.

This is a great time for you to get on board and offer your customers one of the hottest new clothing lines to hit So Cal. Dealer buy in is $500.00. With a minimun of $50.00 there after. Please fill out the following form and you will be emailed your private password to our dealer order pages once you company is approved.

Contact Information

First Name:*

Last Name:*

Company Name *

Title

Email Address *

Primary Phone *

Secondary Phone

Fax

Owner Address*

 

City*

State* -- AL AK AR AZ CA CO CT DC DE FL GA HI ID IA IL IN KS KY LA MA MD ME MI MO MN MS MT NC ND NE NH NJ NM NY NV OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

Zip*

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Company & Shipping Information

Company Address*

 

City*

State* -- AL AK AR AZ CA CO CT DC DE FL GA HI ID IA IL IN KS KY LA MA MD ME MI MO MN MS MT NC ND NE NH NJ NM NY NV OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

Zip*

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Shipping Address (if different)

 

City

State -- AL AK AR AZ CA CO CT DC DE FL GA HI ID IA IL IN KS KY LA MA MD ME MI MO MN MS MT NC ND NE NH NJ NM NY NV OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

Zip

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Company Information

Website URL

At present location since  

No. of Stores and Locations

Years Incorporated

State of Incorporation

Owner Social Security No.

Fed Tax ID No.

Resale No.

Business License No

Description of Company and Services it provides

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Business References

Business Reference Name

Business Reference Account No.

Business Reference Address

 

State -- AL AK AR AZ CA CO CT DC DE FL GA HI ID IA IL IN KS KY LA MA MD ME MI MO MN MS MT NC ND NE NH NJ NM NY NV OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

Zip

Phone

Fax

Email

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Bank information

Bank Name

Bank Account No.

Phone

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Thank you for taking the time to fill out our Dealer Inquiry Form. Upon submission, a staff member will contact in a timely manner.