Dealer Registration | Dealer Connect Auto Auction

Dealer Registration Form

Thank you for your interest in doing business at Dealer Connect Auto Auction. Here is a registration package for your convenience which upon completion can be faxed back to us at 731-423-5551 or e-mail to sales@DealerConnectAutoAuction.com. We must have the original on file. Please mail it to us at Dealer Connect Auto Auction 50 Fiberglass Rd. Jackson, Tn 38301.

The "Bank Authorization Form," containing three years of your banking history, must be completed by and mailed from your financial institution(s). Please make copies if more than one banking institution must be solicited in order to obtain three years of your personal and/or business banking history. They may fax this information from their office, but the auction is required by its insurance company to maintain the original on file.

We will also need a copy of your dealer's license and a copy of salesmen's licenses for each buyer on the account and a copy of your sales tax certificate.

If you have any questions, please call us at 731-423-5551. We look forward to doing business with you.

Dealers Application

Date:

Dealer Name:

Date Organized:

Type of Business:

Ind. Corp. Partnership New / Used Wholesale

Request to:

Buy Sell Both

Mailing Address:

Bus. Phone:

Bus. Fax #:

Physical Address:

Owners Name:

Home Phone:

Social Security Number:

Cell Phone:

Owners Name:

Home Phone:

Social Security Number:

Cell Phone:

Authorized Reps.

1. Name:

Phone:

SS#:

Cell:

2. Name:

Phone:

SS#:

Cell:

3. Name:

Phone:

SS#:

Cell:

Banking Information

Method of payment:

Cash Checks (With Approval Only)

**Banking Information must go back 3 years

1. Bank

Account Number:

Address:

Contact Name:

Phone:

2. Bank:

Account Number:

Address:

Contact Name:

Phone:

References

(Other Dealers Registered Here)

1. Name:

Phone:

Dealer Number:

2. Name:

Phone:

Dealer Number:

(Other Auctions Attended)

1. Name

How Long:

2. Name

How Long:

Dealer Tag Number:

Dealer License Number:

Sales Tax ID Number:

How did you hear about our auction?

Power of Attorney

Known all men by these Present,

Does hereby make, constitute and appoint Dealer Connect Auto Auction, LLC of Jackson, TN, to execute any and all documents pertaining to the purchase or sale of vehicles that are processed through their auction until this Power of Attorney is revoked by

by written notice to Dealer Connect Auto Auction, LLC/Jackson, TN.

Authorized Signature:

Sworn to and Subscribed before me this

Day

Month:

Year:

Notary Public:

Commission Expires:

The following representative(s) is/are authorized to deliver documents and payment to Dealer Connect Auto Auction, and likewise authorized to receive documents and payment on behalf of the undersigned dealership:

(Please print representative’s name clearly as it appears on driver’s license / picture ID may be requested at the counter)

1. Representative’s name:

Date added:

Date deleted:

2. Representative’s name

Date added:

Date deleted:

3. Representative’s name:

Date added:

Date deleted:

4. Representative’s name:

Date added:

Date deleted:

5. Representative’s name:

Date added:

Date deleted:

6. Representative’s name:

Date added:

Date deleted:

7. Representative’s name

Date added:

Date deleted:

8. Representative’s name:

Date added:

Date deleted:

9. Representative’s name:

Date added:

Date deleted:

10. Representative’s name:

Date added:

Date deleted:

It is understood that Dealer Connect Auto Auction must be contacted in writing to delete authorization of the above listed individuals.

Authorized and agreed to by: (Printed Company Name)

Printed Name of Company Official:

Title:

Sign Name:

Date:

After submitting the form, the PDF file will be available for download