Dealer Information

Dealership Name *

Business Type *

Business Owner’s Name *

Website URL *

Distribution Intent *

eCommerce
Brick & Mortar Location
Both
Other

Street Address Line 1 *

Street Address Line 2

City *

State *

Zip Code *

Country *

Applicant Contact

This is the owner, manager or authorized representative submitting the application.

Applicant Name

Job Title

Applicant Email *

Applicant Phone Number *

Dealer Account & Ordering Contact

If you are the person Zero Gravity should contact to complete the dealer account setup and contact regarding orders, check the box below.

Same as applicant contact

If different, please provide the contact information below for the person we should contact regarding account setup and orders.

Ordering Contact Name *

Job Title *

Ordering Email *

Business and Tax Information

Employer Identification Number (EIN) *

Business License Number *

Does your state, province or country issue or require resale documentation? *

Resellers Permit Copy *

Upload your resale certificate, sales tax exemption certificate or equivalent resale documentation.

Supported format: JPG, JPEG, PNG, PDF

temp-for-156043-file2-1_

Company References

Please provide three companies with which your dealership currently has an established business account.

Company Reference 1 *

Account Number *

Contact Name *

Contact Email *

Company Reference 2 *

Account Number *

Contact Name *

Contact Email *

Company Reference 3 *

Account Number *

Contact Name *

Contact Email *

Additional Info

Applicant Acknowledgment

I certify that the information provided in this application is accurate and that I am authorized to submit this application on behalf of the dealership.

DEALER acknowledges that it has read and agrees to abide by the terms and conditions of the Zero Gravity Refund Policy and Shipping Damage/Discrepancy Claim Policy found on the Zero Gravity website. Legal Stuff 1. Credit Card Payment – Dealer agrees to pay for all orders by credit card in advance of shipment of any product. 2. Collection – Dealer further agrees that if the services of a collection agency become necessary to collect any monies owing hereunder and/or if litigation becomes necessary to enforce this Agreement, Dealer agrees to pay such collection agency fees, attorney’s fees and court costs as may be reasonably necessary to collect such monies. 3. California Law – Dealer acknowledges and agrees that the provisions of this Agreement shall be governed by the laws of the State of California, U.S.A. and shall include the terms and conditions set forth on the Zero Gravity Terms and Conditions page. Any lawsuit to enforce this Agreement shall be filed in any competent court in the State of California, County of Ventura, including, but not limited to, small claims court, and Dealer consents to the jurisdiction of said court(s). 4. Guarantee – Dealership and Owner jointly and severally and unconditionally guarantee to the Manufacturer the prompt and full payment of all sums due hereunder and agree to remain fully bound personally on this guarantee notwithstanding any extension, forbearance, waiver, release, discharge or substitution of any collateral or security for the debt. In the event of default, the Manufacturer may seek payment directly from the undersigned, from Dealership and/or the above-named owner(s). This Guarantee shall be binding upon and inure to the benefit of the parties, their successors, assigns and personal representatives. The undersigned signatory represents and warrants that he/she is fully authorized to execute this Agreement and to bind the Dealership to the terms and conditions of this contract. 5. Attachment – The terms and conditions set forth on the Zero Gravity Terms and Conditions page are made part hereof. This Agreement cannot be modified by any oral statement and is the entire agreement between the parties. Company Info History Videos Media Testimonials Windscreen Series Windscreen Colors Links Customer Service Contact Us FAQs Instructions/Tech Warranty Claims Shipping Damage/Discrepancy Dealers Importers Sponsorships Privacy Policy Returns Terms Of Service Follow Zero Gravity

Zero Gravity Dealer Application

Dealer Information

Applicant Contact

Dealer Account & Ordering Contact

Business and Tax Information

Company References

Applicant Acknowledgment

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