Instructions:
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indicate required fields. Please complete all the required fields and click on the Proceed button.
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Dealership Information
Store Name
*
Legal Business Name
*
Organization Type
*
Corporation
LLC
Partnership
Sub-Chapter S
Sole Proprietorship
Federal TaxID
*
State TaxID
Dealer License #
*
Dealer License State
*
AA
AE
AK
AL
AP
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Years in Business
*
Address1
*
Address2
ZIP Code
*
City
*
County
*
State
*
AA
AE
AK
AL
AP
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Phone1
*
Phone2
Fax1
*
Fax2
Primary Collateral Sold
*
Auto
Auto - Classic Cars
Auto - Conversion
Trucks - Commercial
Marine
RV
Powersports - Motorcycle
Powersports - ATV
Powersports - UTV/Side-by-Side
Powersports - Personal Watercraft
Powersports - Snowmobiles
Powersports - Side Cars
Powersports - Golf Cart
Powersports - Trailers
Trailers
Tractors
Piano
Internet Access
None
Dial Up (Phone Line)
Cable Modem
DSL
Fractional T1
T1
Wireless
ISDN
AOL Dialup
AOL Broadband
Satellite (Low)
Satellite (High)
Dealer Management System
*
Website
How did you hear about us?
*
Website
Direct Mail
Previous Customer
Email
Lender Setup
Industry Publication
Service Company Setup
OIADA
NIADA
Wells Fargo
F&I Express
NMIADA
AppOne Rep
Penn Warranty
PIADA
User Information
First Name
*
Last Name
*
Email Address
*
Title
*
Director
Manager
Officer
Owner
Partner
President
Mobile Phone
*
Desired Username
*
Security Question
*
What is your favorite pet's name?
What is your mother's maiden name?
What was your high school mascot?
Which city were you born in?
Security Answer
*
I hereby certify that I am the Owner Principal OR General Manager of this dealership and have the necessary authority and approval to enter this dealership into legally binding Agreements with AppOne, Inc. I further certify that I have read and accept the terms and conditions of the agreement above on behalf of my dealership.