New Dealer Inquiry Request | credit.riemer.com

Business Address

Country

Street address

City

State

Zip code

Owner

Owner Information

Owner First Name

Owner Last Name

Work Telephone

Email Address

Have you ever filed personal bankruptcy?

Yes

List date(s) of bankruptcy:

Does the business have additional owners?

Yes

Home Address

Country

Street address

City

State

Zip code

Owner #2

Owner #2 Information

Owner First Name

Owner Last Name

Work Telephone

Email Address

Have you ever filed personal bankruptcy?

Yes

List date(s) of bankruptcy:

Does the business have additional owners?

Yes

Home Address

Country

Street address

City

State

Zip code

Owner #3

Owner #3 Information

Owner First Name

Owner Last Name

Work Telephone

Email Address

Have you ever filed personal bankruptcy?

Yes

List date(s) of bankruptcy:

Does the business have additional owners?

Yes

Home Address

Country

Street address

City

State

Zip code

Owner #4

Owner #4 Information

Owner First Name

Owner Last Name

Work Telephone

Email Address

Have you ever filed personal bankruptcy?

Yes

List date(s) of bankruptcy:

Does the business have additional owners?

Yes

Home Address

Country

Street address

City

State

Zip code

Owner #5

Owner #5 Information

Owner First Name

Owner Last Name

Work Telephone

Email Address

Have you ever filed personal bankruptcy?

Yes

List date(s) of bankruptcy:

Home Address

Country

Street address

City

State

Zip code

Store Photos

PLEASE NOTE: Photoshopped or doctored photo submissions will result in immediate survey denial.

Upload Store Front Photos

Upload requirements

Upload Interior Store Photos

Upload requirements

What type of store(s) do you operate?

Footwear

Apparel

Work

FR Apparel

Other…

ASI Number

E-Commerce

Yes

Are you a 3rd Party (3P) Seller?

Yes

Please Select:

Amazon

eBay

Other…

Number of store locations you operate:

Type of Business (Select all that apply)

National Chain

Regional Chain

Mobile Units

Omni Channel

Brick and Mortar

Other…

Do you belong to a buying co-op and desire to have your central billing through it?

Yes

Are you an Industrial Distributor?

Yes

What is your Distributor Address?

Are you working with an Ariat Sales Rep?

Yes

Enter name of rep

Why you would like to become an Ariat Dealer?

Confirm Acknowledgement

Please note: One submission per calendar year. Any duplicate submissions within a calendar will automatically be denied.

I acknowledge the terms of this new dealer inquiry and that this is not a dealer application.

The New Dealer Inquiry review process will be 6 – 8 weeks from the date we receive your completed inquiry.

We will contact you with the next steps. If you are approved to move forward to becoming an Ariat Dealer, we will send you a link to apply to open an Ariat New Dealer Account.

I have read and accept this acknowledgment

Your Name

Position

Phone Number

Email Address

Applicant Email

Enter your email and a copy of your submission will be sent to you