Commercial Accounts Application Form

* Name of Company:

Type of Company:
  Corporation LLC Partnership Sole Proprietor

DBA Name:

Federal Tax ID:

* Business Type:

* Years in Business:

* Billing Address:

* Email:

Company Website:

* Phone:

Fax:

* Name of Principal Contact:

Preferred Method of Contact:
Email     Phone    

Would you like to receive our eMail Specials?     Yes     No    

If you ship outside of the USA do you use a freight forwarder     Yes     No    

 

Freight Forwarder Name:

Freight Forwarder Address:

 

City:

State:

Zip:

 

Authorization:

The following individuals are authorized to purchase using this Commercial Account. There is a limit of three names.

Name 1:

Name 2:

Name 3:

Business Description:

Marina/Boat Yard
Marine Retailer
Boat Builder/OEM
Charters/Rentals
Yacht Club

Repair/Service Department
Government or Municipality
Commercial Fishing
Educational Institution
Export

Other: Please Explain:

Click here to view our Terms of Sale

If your billing address is within the USA please fill out the following if you wish to purchase via www.Defender.com

Please note the log in and password must contain a minimum of eight (8) characters and a maximum of twenty six (26).
Password MUST include at least 1 uppercase and at least 1 non alphabetized character

* Preferred Login:

* Preferred Password:

Submit this complete application and email or fax a copy of your state Sales & Use Tax Resale Certificate:

1. Email: comaccounts@defender.com
2. Fax: 1-800-654-1616

Please note applications are normally processed within 72 hours of receiving a completed application

* = Required fields