Form 1 New SVC Dealer Application

DEUTZ Distributor / Dealer Inquiry

Form 1
Application Date *

Month Day Year
Date
Desired Scope *

Distributor CC3 Full Service Dealer CC2 Limited Service Dealer
"PD" Code
"PD" Code
"PD" Code
CC2 Dealer Type

Standard CC2 Ditch Witch CC2 DEUTZ Direct Rental CC2
Industry Type *

Agriculture Construction Rental Power Generation Airport GSE Marine Petroleum Oil and Gas Mining/Quarry/Aggregates
Briefly explain your business approach to providing for the Full Service needs of the DEUTZ brand in your area. *
Please be aware that the financial transaction for parts purchases occurs through the local distributor. This process is necessary to decrease parts lead times and minimize unreimbursed freight costs to the customer.
Are you agreeable to transacting your parts through the local distributor? *

Yes No
Describe why you would rather transact outside of the distributor. *
This document is an application only. Upon approval and review by DEUTZ Corporation, the applicant and the network service provider will agree upon applicant's non exclusive territory and their respective obligations, responsibilities and functions by signing a Service Dealer Agreement.
This document is an application only. Upon approval and review by DEUTZ Corporation, the applicant and the network service provider will agree upon applicant's non exclusive territory and their respective obligations, responsibilities and functions.
Applicant Name *

First Name Last Name
Applicants E Mail *
example@example.com
Business Name *
Applicants Phone Number *

Area Code Phone Number
Business Web Address *
ex: Business.com
OEM Information

Application
Please list the OEMs you are applying to represent with the application of this form.
OEM 1
OEM Name
Contact OEM

First Name Last Name
OEM 2
OEM Name
Contact OEM 2

First Name Last Name
The foregoing application is submitted in good faith. Applicant understands this application does not bind either party to enter into a Service Dealer Agreement for DEUTZ Products. Any option on real estate or other investment or commitment made by the applicant in contemplation of such an agreement will be at the applicants discretion and risk. Applicant confirms no representations or statement have been made on behalf of Distributor or DEUTZ Corporation that would modify or change the terms of this application, except as follows:
Exceptions: *

None YES
List Exceptions
Business Locations
This form will allow you to submit a formal request for up to 10 locations. Please enter the address of each location that you are requesting DEUTZ set up as an authorized DEUTZ dealer or distributor. Please list your primary location or main office in the first entry box.
How many locations do you want to sign?

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Primary Location Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Business Phone *

Area Code Phone Number