HeadlightSticker™ Dealer Application

  • HeadlightSticker™ products are distributed through our network of certified dealers. Certified dealers must be professional, licensed installers in their state of operation.

    Approval process time may vary. To expedite approval, you can send us the following documents:

    • Contractor or Installer License
    • State Resale Certificate
    • W9

    This program is intended for professional installers. End users (e.g. property management or administrators for locations requesting an installation) should instead place a request to find a dealer.

     

    ***All Dealers are onboarded with Cash Before Shipment (CBS) payment terms for the first six (6) months from their first order with HeadlightSticker™. Terms may be reevaluated after six (6) months upon written request. The Dealer Application may need to be resubmitted.

  • Payment Type Requested*

  • Company Information

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  • Account Information

  • Date Business Started
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  • Business Type*
  • Type of Corporation
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  • Do you have a contractor's license?*
  • My state and local government does NOT require that our company have a contractors or electrical license to install this product
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    Cancelof
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    Cancelof

  • Points of Contact

    Placing Orders
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  • Do you require a PO before we process an order?

  • Points of Contact

    Accounting/Accounts Payable
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  • Points of Contact

    Business Owner / Corporate Officer
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  • Bank Information

    The following information is for the purpose of obtaining credit.
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  • Active Trade References

  • Please list references of vendors and/or clients that will validate your business as a member of access control / security / integration industries.

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  • Liability & Officer Guarantee

  • GUARANTEE: I understand and agree that we are liable for any indebtedness caused by the applicant to HeadlightSticker™, and all costs of collection, attorney's fees, expenses, and interest related thereto.

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  • Authorization

  • I hereby authorize HeadlightSticker™ to perform any and all inquiries necessary to validate my application*
  • I attest that all information above is true and will be used for the purposes of validating credit.

  • I hereby acknowledge that I have read, understand, and agree to the dealer terms and conditions set forth above.

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  • Today's Date*
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