New Customer Form

New Customer Form
We are Wholesale only
We only sell to business's with proper resale tax documentation and
that do business in an automotive related industry.

Thank you for requesting to set up an account with us. Please fill out the form below and fax us a copy of your state Retail Sales Tax Permit. Our fax number is 401 724-0469. Note: If you are located in New England or New York State you must also mail us a completed copy of your state's Retail Sales Tax Form. This form can be downloaded via the links listed at the bottom of this page.

Business Name:
Mailing Address:
City / Town:
State:
Zip Code:
Shipping address if different than mailing:
Street Shipping Address:
City / Town:
City / Town:
Zip Code:

Business Telephone:
Fax Number:
Web Address:

Primary Contact:
Position:
Email Address:
Alternate Contact:
Position:
Email Address:

Do you want a password for our website ?:Yes No<
Do you want a printed catalog ?: Yes No

Note: If you are located in New England or New York State you must also mail us a completed copy of your state's Retail Sales Tax Form. This form can be downloaded via the links listed here.

- Connecticut Tax Forms
- Maine Tax Forms
- Massachusetts Tax Forms
- New Hampshire Tax Forms - Not required
- New York Tax Forms
- Rhode Island
- Vermont Tax Forms

These forms are in Adobe Acrobat. If you need a viewer click here to download a viewer for free.