Retail Account Application

Retail accounts are businesses that operate out of a storefront or outlet with public access for customers. The business must also sell associated merchandise at retail prices or provide product as part of service. Retail accounts cannot resell AMSOIL products online or through retail catalogs.

Examples of Industries We Serve

Auto Parts & Hardware Stores
Powersports Stores
Full-Service Garages
Quick Lubes
Powersports Dealers
Auto Dealers

Retail accounts buy AMSOIL products at wholesale prices and are eligible for special freight and payment terms. All retail accounts qualify for co-op advertising support based on the amount of AMSOIL products purchased. Qualified retail accounts can also appear on the AMSOIL locator at www.amsoil.com.

Note: This application will not immediately result in an AMSOIL Retail Account. New requests will be processed for businesses that can be substantiated by internet and industry research.

Fill out and submit the following information. An AMSOIL account representative will contact you within two business days.

^* Indicates a Required Field

Company Name: ^*

DBA Name:

Billing Address: ^*

City: ^*

State/Province: ^*

ZIP/Postal Code: ^*

Phone: ^*

Fax:

Website:

Business Type: ^*

First Name: ^*

Last Name: ^*

Title: ^*

Contact Phone: ^*

Email Address: ^*
(Cannot be AMSOIL Referring Dealer)

Confirm Email Address: ^*

Owner's Name: ^*

Number of outlets owned/operated: ^*

Brand/Franchise affiliation:

Does the business operate out of a storefront with public access?

Yes No

Do you have a current order pending?

Yes No

Are you working with an Independent AMSOIL Dealer? Enter their info here:

Have a Referral Number? Enter it here:

Would you like to submit your tax exempt certificate? (Can be submitted later if information is unavailable)

Yes No

Tax Exemption

Description of Business: ^*

Is engaged as a registered: (Please check all that apply)

Whole Saler

Manufacturer

Lessor

Retailer

Seller

Other

General description of tangible property or taxable services to be purchased from the seller:
All Products Available for Sale by AMSOIL INC.

The following states require state specific forms: Alaska, Florida, Indiana, Louisiana, Massachusetts, New York, Virginia, West Virginia, Wyoming. Please refer to your states specific tax exempt form. After you receive your account number, please send the required state-specific form to [email protected]

Please provide the State Registration Seller’s Permit or I.D. Number or Purchaser for the state in which you are registered.

State ^*

Tax Id ^*

Would you like to apply for net-30 credit terms? (Can be submitted later if information is unavailable)

Yes No

Credit Application

Date Business Established: ^*

Federal Id Number: ^*

Credit Amount: ^*

Are Purchase Orders Required?

Yes

Owners/Partners/Corporate Officers

Name

Title

Credit References

Company Name: ^*

Account #: ^*

Phone: ^*

Email: ^*

Company Name: ^*

Account #: ^*

Phone: ^*

Email: ^*

Company Name: ^*

Account #: ^*

Phone: ^*

Email: ^*

I agree to the following

I affirm that I am authorized to submit this application on behalf of the above‑named business to establish an AMSOIL account for purchasing AMSOIL products. I understand that approval of this account allows the business to sell or install AMSOIL products through physical retail outlets only, and that AMSOIL products may not be sold through internet websites or printed catalogs.

Marketing communications (optional)

I agree to receive marketing emails and other messages from AMSOIL about products, promotions, and company updates. I understand that I can unsubscribe or manage my preferences at any time.

CREDIT TERMS AND AUTHORIZATION:

I, the undersigned, am duly authorized to submit this application on behalf of the above-named company (“Applicant”) for the purpose of establishing a credit account with AMSOIL INC. ("AMSOIL").
By signing below, Applicant represents and warrants that the information provided is true, correct, and complete as of the date submitted, and agrees to promptly notify AMSOIL of any material changes.
Applicant authorizes AMSOIL and its designated agents to verify the information provided herein, including obtaining bank references, credit reports or other relevant information related to establishing credit.
Applicant acknowledges and agrees that AMSOIL may disclose the information provided in this application to third party credit reference agencies or service providers for the purpose of verifying the information and assessing Applicant’s creditworthiness.
Applicant understands and agrees that AMSOIL’s decision to extend or deny credit may be based in whole or in part on information provided by third party credit reporting agencies. Applicant agrees that AMSOIL will not be liable for the accuracy or completeness of such third party information.
If approved, all purchases will be subject to Net 30 days payment terms and AMSOIL at its discretion, may impose interest of one and one-half percent (1.5%) on all past due balances until paid in full.
Applicant acknowledges and agrees that AMSOIL may suspend credit privileges and/or refuse to process orders on accounts more than thirty (30) days past due. AMSOIL will refer accounts that are more than ninety (90) days past due to collections with all recovery costs (including reasonable attorney fees) to be borne by Applicant.
Approval of this application and extension of credit shall not obligate AMSOIL to continue to sell or extend credit to Applicant. AMSOIL’s decision to extend, withdraw, or deny credit may be made at its sole discretion without any liability.

By submitting this form, you agree to the General Terms and Conditions and AMSOIL Privacy Policy.

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Retail Account Application

Tax Exemption

Credit Application

Owners/Partners/Corporate Officers

Credit References