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Dealer Application

IF YOU ARE ALREADY A HADLEY DEALER YOU DO NOT NEED TO COMPLETE THIS FORM.
If you need your user name and password to access the dealer portion of the site, please use the "Contact Us" link and provide your gallery name and address.

To apply to be an authorized Hadley Dealer,
please first download and review the Dealer Requirements file using the link below. If you meet those requirements, please fill out and submit the form below. We will review it and contact you regarding the status of your application and at that time will ask for additional documentation if needed.

Dealership Requirements.pdf

Required fields are marked with a (*)

Business Name: *
DBA Name:
Business Type: *
Phone: *
Fax:
Address: *
Email: *
City: *
State: *
Zip Code: *
Other present locations:
Date Business Established: *
(11/19/2007)
Federal Tax ID: *
Duns#:
State Registration # *
Seller's Permit #:
Exempt:
Owner/Officer #1
Owner/Officer's Name: *
Home Address: *
City: *
State: *
Zip Code: *
Home Phone: *
Social Security Number:
Owner/Officer #2
Owner/Officer's Name:
Home Address:
City:
State:
Zip Code:
Home Phone:
Social Security Number:


Trade References - Please complete names, addresses, and telephone numbers
1. Name: * 2. Name: *
  Address: *   Address: *
       
  Phone: *   Phone: *
  Account #: *   Account #: *
3. Name: 4. Name:
  Address:   Address:
       
  Phone:   Phone:
  Account #:   Account #:
Banking Information
1. Name: * 2. Name:
  Address: *   Address:
       
  Phone: *   Phone:
  Account #: *   Account #:

I HEREBY AUTHORIZE Hadley House Company or its credit agent to investigate the references herein listed or any statements of data obtained from me or from any other person pertaining to my credit and financial responsibility. Further, as part of the application for credit, we grant permissions to contact consumer credit reporting agencies and commercial credit reporting agencies as necessary. I agree to pay all invoices within stated terms and to pay all service charges on amounts paid after invoice due dates at a rate of 1.5% per month or the maximum allowable rate, whichever is less. In addition, I agree to pay all costs (including actual attorney and collection fees) incurred in the collection of any unpaid amount. Hadley House Company may, at their option; commerce legal action based upon this application in the Minnesota courts. In that event, I consent to the jurisdiction of Minnesota courts. I also agree to be bound by the terms of the Hadley House Company "Dealer Requirements", a copy of which has been furnished to me.

I certify that the given information is true and correct. I have read this agreement and I agree with the provisions as stated. A copy of this agreement is available upon request from the credit department of Hadley House Company.

Company Name * Date *
(11/19/2007)
Your Name * Requested Credit Limit *

In consideration of the extension of credit to the above named corporations, I PERSONALLY and INDIVIDUALLY hereby unconditionally guarantee payment of whatever amount shall at any time be past due including all expenses of collection (and actual attorney and/or collection fees) on any account of goods hereafter delivered or services performed by you to said corporation. This shall be on open and continuous guarantee and shall continue in force notwithstanding any change in the form of such indebtedness or renewals or extensions granted by you.

Personal Guarantor * Date *
(11/19/2007)