Company Name: 

Owner Name:    Manager Name: 

Business Phone:    Fax: 

Address:    City: 

State:    Zip:    Email: 

Primary Business:    Years in Business: 

Number of Employees: 

Which state(s) are you currently doing business in? 

State Business License #: 

State Resellers Permit Number: 

State Contractor's Permit Number: 

What other products do you currently sell? 

List vendors you are currently working with: 

Do you supply products to contractors and/or builders? 

If so, list all builders you are currently doing business with: 

What City and State do you want to sell the TUFFRAX® overhead storage products? 

What form of advertising or marketing are you currently doing? 

If you have a website please provide the address: 

Have you sold garage overhead Storage systems: 

If Yes, what is the brand? 

Do you currently have a warehouse to stock your TUFFRAX® inventory? 

When would you like to get started? 

What is the best time and number to reach you?