SHARP METAL Dealer Application

Made in the USA

Date: ________________ Email Address: _________________________________

Company Name: ________________________________________________________

Address: _______________________________________________________________

City: _____________________ State: _____ Zip: __________ Country: ____________

Phone: ___________________________ Fax: ______________________________

Owners Name: ___________________________Home Phone: ____________________

Owners Home Address: ___________________________________________________

City: ____________________ State: ______ Zip: ___________ Country: ___________

Business Type: __________________________________ Franchised: ____________

Officer: _______________________________ Title: ________________________

Brand 1: ________________________________________ Dealer #______________

Brand 2: ________________________________________ Dealer # ______________

Brand 3: ________________________________________ Dealer # ______________

Tax ID#: ____________________ Years In Business: ______ Years At Location: _____

Square Footage: ______________

Bank Reference:

Bank Name: ______________________________________ Account#: ______________

Name on Account: ________________________________________________________

Bank Address: _______________________ City: __________ State: ___ Zip: ________

Phone: ______________________________ Fax: _________________________

Authorization Signature for Credit Information Release:

_____________________________________________ Date: ____________________

Supplier References:

Reference 1: ________________________________________________ Terms: ______

Phone: ____________________________ Fax: ______________________________

Reference 2: ________________________________________________ Terms: ______

Phone: ____________________________ Fax: ______________________________

Reference: 3: _______________________________________________ Terms: _______

Once we have received your completed application and make the necessary inquiries we will contact you with your account status. Note: You may be asked to complete a new Dealer Application in the event your Name and/or address changes.

Fax your Application To: 405 899-4549 or Mail To:

SHARP METAL FAB. INC.

8401 156^th Ave.

Noble, Ok 73068