Become a Dealer | Icon Vehicle Dynamics -

Distributor Application Form

If you are interested in becoming a distributor for ICON Vehicle Dynamics, please read and fill out our online application form below in its entirety.

We also have a Printable Dealer Application Form, email our team at [email protected] requesting the PDF.

Thank you!

Company Info
Company Name:*
Company Address:*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone:*
Example: 9516894266 (NO SPACES)
Fax:
Federal Tax I.D.:*

Example: 95-123456
Seller Permit Number:*
Company Website Address:
Sales E-Mail Address:
Accounting E-Mail Address:
Sales Info:
What vehicles makes do you deal with the most? (i.e. Ford, Toyota, GM etc.):
How do your customers hear about you? (i.e. Word of Mouth, Online, etc.):
Do you advertise in your city? (i.e. Billboards, Signs, etc.):
Do you advertise online? (i.e. Banner Ads, Company Website etc.):
Do you have an online store?:
Do you have a showroom where you display the products you sell?:
Do you offer installation?:
Contact Info:
Owner's Name:
First Last
Accounts Payable Clerk:
First Last
List Authorized Purchasers:
In order to complete this application, a copy of your Re-Sale Card and Business License MUST be faxed in to 951-689-1016. All orders will be shipped PrePaid. For open account terms, a Credit Application must be completed and approved by the ICON Vehicle Dynamics Accounting Dept.
7929 Lincoln Ave. Riverside, CA 95204 | ph. 951.689.ICON | fx. 951.689.1016
This information may be shared with an authorized ICON distributor, completion of this form and clicking ‘Submit’ indicates you agree to these terms.

Distributor Application Form

Company Info

Sales Info:

Contact Info: