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Legend Distribution Preliminary Dealer Application

Your Name
Store Name
Address
City, State
Zip
Phone / Fax
Buyers Name
Type of Business
Number of Locations
List 3 brands you carry
Federal Tax ID
Reseller Tax ID
Choose Products you would like further info on




email address
Image Verification
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Please note- Terms and Delivery: All orders are shipped UPS. First Three orders are C.O.D. cashier check or Credit Card payment only, after third order company check is o.k. A $15.00 charge is assessed for all returned checks, after 1 returned check company will be placed back on cashier checks or credit card only.