Dealer Application

Section 1: Vendor General Information

Business Name *

Website URL

Business Street Address

City

State

Zip Code

Contact Name (Last Name, First Name) *

Contact Email *

Contact Phone *

Section 2: Vendor Classification

Select Business Entity Type

Individual
Partnership
Corporation
Limited Liability (LLC)

Years in Business

FEIN Number

State Incorporation

PO Required

PO Email: Email for Purchase Orders

Section 3: Tax Certifications

Please select and complete the appropriate tax certification. Include a signed copy with this form.

IRS Form W-9 (U.S. individuals & entities)
IRS Form W-8BEN (foreign person)
IRS Form W-8BEN-E (foreign entities)

Click here to get IRS Form W-9

Attachments

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-67353-file2-2_

Mail or fax this form and the applicable completed IRS form to:

Accounts Payable:
5701 NW 35 Ave.,
Miami, FL, 33142

Email: ap@swcorp.com

Fax: 866-560-1060

Additional Information

Representative Name

Cell Phone

Other Phone

Accounts Rec. Name

Phone Number

Secondary Contact Name

Phone Number

Signature Name

Signature of Officer/Owner (Name)

Date

Title

By checking this box, I confirm that all the information provided above is true and accurate to the best of my knowledge.

Thank you for your submission.

You're application has been sent for review. We will be in touch with you within the next 1-2 business days.

Thank you for your submission.

You're application has been sent for review. We will be in touch with you within the next 1-2 business days.

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