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Name
*
Dealership Name
*
Login Name
*
Password
Date
FED ID #
Acct#
Firm's Name
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Phone
Shipping Address
*
Email
*
City
County
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State
Zip
Billing Address
Phone
Fax
City
County
State
Zip
# of Years in Business
Purchasing Agent
Types of Business
Select
Corporation
Partnership
Proprietorship
LLC
State of Incorporation
Branch/Subsidiary of
Nature of Business
Years at Present Location
Location
Select
Owned
Leased
Credit Limit Requested $
Annual Sales $
Accounts Payable Manager
Phone
Fax
Bank Name
Phone
Acct #
Bank Address
City
State
Zip
Bank Contact Person
Phone
Fax
Type of Account
Select
Commercial Checking
Checking
Savings
Loan $
Secured by Inventory
Accts Receivable?
Name
Title
SSN #
Home Address
Phone
Name
Title
SSN #
Home Address
Phone
Accountant's Name
Phone
Address
Fax
Name
Acct #
Phone
Fax
Address
City
State
Zip
Name
Acct #
Phone
Fax
Address
City
State
Zip
Name
Acct #
Phone
Fax
Address
City
State
Zip
Name
Acct #
Phone
Fax
Address
City
State
Zip
Friend Tire Company has eight distribution centers located nationwide. Below, please select the distribution center in which you will directly be doing business and receiving inventory. A copy of the above application will be sent to the corresponding branch manager and Friend Tire corporate. You will be contacted once your new account has been approved. If you have additional questions, please call us at 1-800-950-8473. And thank you for your interest in Friend Tire Company.
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Distribution Location
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Monett, MO
Belton, TX
Memphis, TN
Albuquerque, NM
Salt Lake City, UT
St Charles, MO
