Company Name * Company Description * Please tell us about your company in as much detail as possible. What do you do? What foundation was your company built on? What makes your company unique? Type of Business Sole Proprietor Partnership LLC Corporation Company Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Primary Contact * First point-person. First Name Last Name Primary Phone * Primary Email * Secondary Contact * Second point-person. First Name Last Name Secondary Phone * Secondary Email * Purchasing Email * The best email to use for issues with payments, shipping, backorder notifications, etc. Product Management Email * This email will be used to send out updated Dealer Price Lists and updates including upcoming dealer sales, product issues, product preorders and launches, etc. If you are listing our items on your website, the website manager should have access to this email. Company Website http:// Resale Certificate and/or VAT Registration UPLOAD * US Companies: Please upload a Wisconsin Sales and Use Tax Exemption Certificate above and write your Tax ID Number in the box below. The form is found at https://www.revenue.wi.gov/DORForms/s-211f.pdf Companies Outside the US: Please upload your VAT Registration above and write your VAT Number in the box below. If a non-VAT country, please list your equivalent tax information and provide documentation. Resale/VAT Issuing Authority * State or country issuing your resale tax number, VAT number, or equivalent. Do you install performance parts? * If yes, please put your shop address below so we can send customers to you for installs. Yes No Shop Address If you would like us to recommend your shop to our customers for installs. Address 1 Address 2 City State/Province Zip/Postal Code Country Thank you! Your application has been submitted. If approved, we will reach out to the Primary Email with instructions on how to use the dealer program. In preparation, please add @jxbperformance.com to your email’s safe sender list. We often end up in the spam folder.
