AMSOIL Dealer Application & Agreement

Individual

LEGALLY MARRIED COUPLE

$64.95

Retail Price (CAD)

An AMSOIL Dealership may only be owned by an individual or co-owned by a legally married couple. Please select desired ownership structure for your Dealership.

Although a Dealership may only be owned by an individual or married couple, you may elect to have your commissions paid to a legal entity (e.g. a limited liability company or corporation) after your application is approved.

First Name

Last Name

Middle Initial

SIN

Date of Birth (Day/Month/Year)

Occupation

Spouse First Name

Spouse Last Name

Middle Initial

Mailing Address

Address (Apt#, Suite#)

City

Province

Postal Code

Fax

Phone

Direct Deposit

Name of Your Bank

Bank City

Country Code

Currency Code

Routing Number

Account Number

Name(s) on Account

Please accept the terms of service to continue.

I hereby authorize AMSOIL to electronically credit my account at the depository financial institution named above, and if necessary, electronically debit my account to correct erroneous credits. I agree that direct deposits I authorize comply with all applicable law.

I understand that this authorization will remain in effect until I notify AMSOIL in writing or by phone that I wish to revoke this authorization.

If you have a referral number or have been in contact with an independent AMSOIL Dealer, enter the number below...

Referral Number

(if known)

Unable to verify.

Thank you! Tell us who referred you to AMSOIL

All Applicants must read and agree to our Dealer policies. Click here to view them.
Click SIGN AGREEMENT to review and sign the Dealer Agreement.

SIGN AGREEMENT

1 Application Information

2 Commission Info

3 Referral Information

4 Agreement

AGREEMENT SIGNED

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Account Information - Log In or Create Account

1 Application Information

2 Commission Info

3 Referral Information

4 Agreement

AGREEMENT SIGNED