Onboarding ID *
(in email "Sales Dealer Application - Next Steps")
Federal Tax ID *
Business License Number (optional)
Business License Number Upload
Business Phone Number *
Date of Incorporation *
How is the business organized? * —Please choose an option—Sole ProprietorshipGeneral PartnershipS-CorporationC-CorporationLimited Liability PartnershipLimited Liability Company
First/Last Name *
Phone Number *
Email Address *
Has your company ever filed for Bankruptcy Protection? * YesNo
Has there ever been any lawsuits or judgements against your company or any of its owners? * YesNo
Has your company or its owners ever operated under a different name? * YesNo
What was the previous company name?
What are your annual sales? *
What part of the annual sales are financed? *
Estimated monthly install volume with Solanta? *
Please upload copies of your insurance documents endorsed to: *
Solanta Corp d/b/a Solanta 141 Flushing Ave, Building 77, Suite 505 Brooklyn, NY 11205
Solanta Corp d/b/a Solanta
141 Flushing Ave,
Building 77, Suite 505
Brooklyn, NY 11205
'Solanta is covered as additional insurance on the above listed policies' on each certificate.
Company Name *
Contact Name *
Address *
Company Name
Contact Name
Phone Number
Email Address
Address
Bank Name *
Account Number *
Account Officer *
*all who have 10% or greater steak must be listed
How many stakeholders are there? 12
First/Last Name*
Title *
Ownership Percentage *
Social Security Number (SSN)*
Date of Birth *
I (we) agree that the Contractor (Solanta Corp) may procure or verify credit information of the dealer, principals, or account holders from third parties such as other businesses, creditors, or third party reporting agencies. I (we) agree to the Contractor exchanging information about our obligations with references and other business or credit reporting agencies. I (we) further understand that use of a photocopy of this form may be necessary to verify one or more of my (our) credit references. I (we) authorize the use and request of such a photocopy by honored fully. I (we) hereby expressly and directly grant the Contractor permission to transmit to Dealer any type of facsimile or email, including such that advertise the Contractor's products or services to the facsimile number and email provided above.
This authorization shall remain in effect until written notice is given to terminate such Agreement. Please make copies of all documents for your records. I (we) submit the above information as being true, complete and accurate as of the date shown.
1st Stakeholder's Signature (Full Legal Name)
Date
2nd Stakeholder's Signature (Full Legal Name)
3rd Stakeholder's Signature (Full Legal Name)
4th Stakeholder's Signature (Full Legal Name)
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