Bentley Fishing USA Dealer Form

• Name First Last
• Legal Name of Business
• Please e-mail pictures of your facility to: sales@expodex.com
• DBA ( Doing Business As) Name
• Tax Payer Identification Number (ITN)
• Check All That Apply Below Applying for a new BFUSA dealer account Buying of an existing BFUSA dealer Oppening an additional dealer location
• Address
  Street Address
  Address Line 2
  City
  State / Province / Region
  Postal / Zip Code
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• Phone - (###) - ### ####
• Fax - (###) - ### ####
• Web Site
• Email
• Requested Credit Terms COD Open Account / Credit Line Prepaid

  COD Open Account / Credit Line Prepaid

• Would You Require Drop-Shipments Yes No
• BFUSA Product Line Interest Bobbers / Floats Custom Panfishing / Ice Fishing Jigs Soft Plastic Lures Demon - Patented Lure Retriever Jack - Custom Crankbaits BFUSA - Polish Rooster Baits
• Comments