DEALER APPLICATION

774 W. Marshall Ave.

Willacoochee, Georgia 31650

Telephone: (912) 534-5400

Fax: (912) 534-5416

Full Legal Name of Dealer

(hereinafter referred to as “DEALER”):

PLEASE SELECT ONE:

Sole Proprietorship

Partnership

Corporation

Non-Profit Organization

LLC

Joint Venture

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Mailing Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

County:

Business Phone:

Business Fax:

Business Email:

ARE YOU SALES TAX EXEMPT? (An exemption certificate must be attached)

Yes

Products Currently Being Sold

General Manager Name:

GM Cell:

GM E-mail

In Business Since

Annual Sales: $

Fed. TaxID Number.:

OFFICERS, PARTNERS OR MANAGERS OF DEALER

Name

Title

INDUSTRY REFERENCE

INDUSTRYREFERENCE

Business Name:

Contact:

Phone:

Fax:

BANK REFERENCES

INDUSTRYREFERENCE

Business Name:

Contact:

Account No.:

Phone:

Fax:

TERMS AND CONDITIONS

Dealer, as identified and defined on Page 1 of this DealerApplication, certifies that it is solvent, capable of meeting its obligations under any non-exclusive dealer agreement that may be entered into between Dealer and Freedom Trailers, and that all information (including any requested financial statements) provided to Freedom Trailers, LLC (herein after referred to as “Freedom Trailers”) is true,accurate and complete. Dealer acknowledges that all information has been submitted for the purpose of Dealer’s application to be an authorized non-exclusive dealer of Freedom Trailers’ enclosed cargo trailers. Dealerand each Guarantor authorize Freedom Trailers to request credit reports from credit bureaus (including consumer reporting agencies) regarding their respective commercial or personal credit and to otherwise to investigate their respective creditworthiness prior to entering into any non-exclusive dealer agreement and at any time and from time to time during the term of any non-exclusive dealer agreement entered into between Freedom Trailers and Dealer, as Freedom Trailers deems necessary or prudent in its sole discretion. Dealer agrees that it shall complete all necessary forms to authorize and otherwise to accommodate such credit checks within ten (10) days following Freedom Trailers’written request. Freedom Trailers reserves the right to deny any Dealer Application for any reason, at Freedom Trailers’ sole discretion. Dealer acknowledges and agrees that any past due balances shall bear interest at the rate of 1.5% per month, or the maximum rate permitted by applicable laws. Dealer further acknowledges that in the event that any indebtedness is placed into the hands of an attorney for collection and/or a lawsuit is instituted to collect said indebtedness, or any portion thereof, Dealer, along with the Guarantor(s) named herein, agree and promise to pay all costs and expenses of collection, suit or other legal action, including, but not limited to, all reasonable attorney’s fees and collection costs incurred, as provided by law.

I agree to the terms and conditions.

Print Name:

Title of Authorized Signor:

Signature

Dealer’s Authorized Signature

Date:

DEALER APPLICATION

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