Please fill in the below form to sign up for the dealership program.

Company Name *
 
Contact Name *
 
Secondary Contact
Address *
 
City *
 
State *
 
Zip *
    
Phone *
xxx-xxx-xxxx
Ext:  
Alternate Phone
xxx-xxx-xxxx
Ext:  
Fax
xxx-xxx-xxxx
 
Email *
 
Alternate email
My location is a (check all that apply):
How many locations do you have? *


Other:
 
What are your business hours? *
 


Other:
 
I would like Prepaid VISA Cards and Checks
I would like Checks ONLY
Please list any comments or questions you would like to have answered:
If you know of any other car dealerships that may want to participate in our Tax Max Marketing program, please provide their contact information below.
Dealership:
Phone number:
xxx-xxx-xxxx
Contact: