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Stealth Safe Company > How to become a Stealth Safe Dealer

Please fill out the following form then follow the directions below:

COMPANY INFORMATION

State: Zip:

Shipping Address (If different)

State: Zip:

Phone: FAX:

Email: Web Site:

OWNERS OR OFFICIERS:

Name: Title:

Name: Title:

Name: Title:

Years in Business: Year Established


PLEASE DESCRIBE YOUR BUSINESS:

Type of Business:

Products Sold (Please list as many as you can):

More then one location?  Yes No     If yes how many?

Preferred payment Method:

BUSINESS REFERENCES(Please provide three business references):

Business Name:

Address:

State: Zip:

Phone: FAX:

Type of Product Purchased:

Business Name:

Address:

State: Zip:

Phone: FAX:

Type of Product Purchased:

Business Name:

Address:

State: Zip:

Phone: FAX:

Type of Product Purchased:

I authorize Stealth Safe Company to contact the above References

Signature: Date:

Printed Name: Title:

When finished you can print the form, sign it and FAX it to 1-805-526-1352