Authorized Dealer Application

01 · Company Information

Tell us about your dealership.

Company Name*

Phone Number*

Website

Type of Business*

Corporation Partnership Individual LLC

Mailing Address*

City*

State*

Zip Code*

Shipping address is the same as mailing

Shipping Address*

City*

State*

Zip Code*

02 · Owners, Officers, Directors, Partners

Who runs the show?

List up to two principals. The first is required.

Name*

Email*

Title*

Name Optional

Title

03 · Resale Certificate

Tax-exempt resale.

We need your resale certificate number on file plus a copy of the certificate itself.

Resale Certificate Number*

Upload Resale Certificate*

Tap to attach a PDF or image Choose file

PDF or image (JPG/PNG). Max 10 MB.

04 · Accounts Payable Contact

Who handles the invoices?

AP Contact Name*

Phone Number*

Email Address*

05 · Payment Terms & Authorization

How do you want to pay?

Select one*

Credit/Debit Upon Completion ACH As Agreed

Credit/Debit on file is charged at the time the order ships. ACH terms are set at enrollment.

By signing below, I authorize RG3 Factory to charge the payment method on file for orders placed by me or my appointed buyer at the time of shipment, in accordance with the Payment Terms selected above.

Name (please print)*

Title*

I confirm I’m authorized to sign on behalf of the company, and I agree to the authorization above. By submitting, this serves as my electronic signature (E-SIGN Act / UETA).

A real person reviews every application. We’ll follow up within one business day.

Got it. Thanks.

We’ve received your dealer application and will review it within one business day. We’ll follow up by email at the addresses you provided with the pricing schedule and next steps.