TOMMY'S ALUMINUM TRAILERS

Thomas O., Pat & Rusty Hudson

"Custom Built For You"

15894 County Road 3540         -         Ada, OK     74820

Ph - 1 (800) 889-7785 or 1 (580) 332-7785         -        Fax - 1 (580) 332-7707

24 Hr. Answering Service

DEALER APPLICATION

Company Name:

Address:

City:                                                                                   State:                                             Zip Code:

Business Phone:                                                                              Fax Number:

Corporation:                                         Partnership:                                               Sole Proprietor:

Federal ID # (If Corporation):

State Sales Tax Number:

(Furnish & Attach Copy Of State Sales Tax Certificate)

Type of Business:

Number of Years In Business:

Owner's Name:

Home Phone Number:                                                                          Cell Number:

Social Security Number:

Driver's License Number:

Also Doing Business Under:

BANK REFERENCES:

Name of Bank:

Bank Officer:

Street Address:

City:                                                              State:                         Zip Code:                                    Phone:

TRADE REFERENCES:

#1)     Name:                                                                                                  Phone Number:

Address:                                                                  City:                                          State:                Zip Code:

#2)    Name:                                                                                                  Phone Number:

Address:                                                                  City:                                          State:                Zip Code:

TERMS:

50% DEPOSIT - BALANCE - C.O.D. (COMPANY CHECK)

APPLICANTS SIGNATURE ATTESTS FINANCIAL RESPONSIBILITY, ABILITY & WILLINGNESS TO PAY

TOMMY'S TRAILERS, INC. AND ALSO AUTHORIZES THE BANK INSTITUTION TO RELEASE ANY

INFORMATION REQUESTED BY TOMMY'S TRAILERS, INC.

Signed:                                                                                                                 Date: