New Dealer Application

Dealer Application Fee: Companies wishing to apply to become dealers with Dealer Financial Services must submit an application fee of $100 together with the completed new dealer application form. Dealers who are approved will have $50 of that fee refunded to them at the time they fund their first contract with DFS.

The application fee can be paid by credit card or one-time ACH debit. Please print and complete the payment form found HERE. Fax the completed payment form to: 715-849-4869. You may then complete the dealer application below. Applications received without the payment form will not be processed.

Applying to be a dealer is simple. Complete the form on this page, check the "agree to terms" box below the application, and hit "Submit Application." If any additional information is required, you will be notified by our dealer setup personnel. You will receive an answer within two business days. Upon approval, you will be faxed our dealer agreement to sign. If you prefer to apply by fax, please download the applicationn and payment form HERE and fax the completed documents to DFS at 715-849-4869

If you have any questions on our program or dealer application process, please contact us.

Main Phone: 1-800-234-3663

Shanna Bucki, Business Development Manager
   ext. 1341, sbucki@aquafinance.com

Sadie Franke, Sales & Marketing Assistant
   ext. 1212, sfranke@aquafinance.com

Kirsten Jansen, Sales & Marketing Assistant
   ext. 1191, kskadahl@aquafinance.com

 

Please complete the payment form located HERE and fax to 715-845-4869 before completing this application.

Company Information

Manufacturer/Brand of Products Sold
Company Name
Do not enter apostrophes
Contact Person
Title
Business Address
City
State
Zip
Business Area Code and Telephone Number  
Cell Phone  
Fax  
Email
List States You Do Business In
Do you have other locations to set up?
Are You Licensed In Each State
Year Company Started
Years Of Experience In Field
Average Sale Price of Equipment
Number of Units Sold per Month
How Did You Hear About Us
If Magazine Ad, Please Specify Magazine Name
If Trade Show, Please Specify Trade Show Attended
If Other, Please Specify

Ownership Information (1)

Name
Title
Home Address
City
State
Zip
Home Phone Number
Social Security Number
No Dashes Please
Percent Owned%
Years Owned

Ownership Information (2)

Name
Title
Home Address
City
State
Zip
Home Phone Number
Social Security Number
No Dashes Please
Percent Owned%
Years Owned

Are there any additional owners
with greater than 24% ownership?

Present Financing

Do you currently offer financing to your customers? Yes
No
If Yes, Please List the Other
Finance Companies used

Reference - Bank (1)

Name
Address
City
State
Zip
Area Code and Phone Number  
High Balance$

Reference - Trade (1)

Name
Address
City
State
Zip
Area Code and Phone Number  
High Balance$

The information contained in this statement is provided for the purpose of establishing a credit referral relationship with Aqua Finance, Inc. (hereinafter referred to as DFS) on behalf of the dealer. The dealer understands that DFS is relying on the information provided herein in deciding to grant or continue credit to customers of the dealer who are seeking credit from DFS. The dealer represents and warrants that the information provided is true and complete and that DFS may consider these statements as continuing to be true and correct until a written notice of change is given to DFS by the dealer. DFS is authorized to make all inquiries it deems necessary to verify the accuracy of the statements made herein, and to determine the dealer’s credit worthiness. By submitting this application the dealer grants permission to those to whom inquiry is made to provide all information requested by DFS. DFS is authorized to release information about its experiences with the dealer.

By checking this box, I confirm that I have read and agree to the terms of the Master Account Information Form above. I understand that this is an electronic transaction subject to the Wisconsin Uniform Electronic Transactions Act (UETA) and that my electronic signature is binding. I agree that my electronic signature has the legal effect of a written signature, pursuant to the Wisconsin UETA which governs the terms of the contract and the parties intent to be bound by those terms. I also certify that I am the owner of the company applying and that I am authorized to initiate this transaction.

 
Interested in becoming
a dealer?
Want to access your existing dealer account?
Interested in working for Aqua Finance?