Please fill in the below form to sign up for the dealership program.
 
Company Name *
 
Primary Contact Name *
 
Secondary Contact
Address *
 
City *
 
State *
 
Zip *
Company Phone * xxx-xxx-xxxx
Ext:
Cell Phone * xxx-xxx-xxxx
This number may receive Tax Max text messages.
Ext:
Fax xxx-xxx-xxxx
 
Dealership Website Address
Email *
 
Alternate email
Additional Emails for Drive Now Network Leads:
DNN Email 1:
DNN Email 2:
CRM/ADF Email:
My location is a (check all that apply):
  Buy Here Pay Here
   Car Dealership
   Check Cashing Store
   Collections Agency
   Insurance Company
   Manufactured / Mobile Home
   New Car / Franchise Dealer
   Other
   Pay Day Advance / Cash Loan
Explain:
How many cars per month do you sell? *
How many locations do you have? *
Who is your DMS (Dealer Management Software) provider? *


Other:
 
Who is your Inventory Management Software Provider?
What are your business hours? *
 
How did you hear about us? *


Other:
 
When your customer's refunds are available, how would you like to receive the refunds:
  I would like Prepaid Cards and Checks
  I would like Checks ONLY
  I would like Prepaid Cards ONLY
Please list any comments or questions you would like to have answered:
If you know of any other locations that may want to participate in our Tax Max Marketing program, please provide their contact information below.
Company Name:
Phone number: xxx-xxx-xxxx
Contact: