Become a Dealer

Point of contact

OWNER OR AUTHORIZED REPRESENTATIVE*:

TITLE

PRIMARY PHONE NUMBER*:

EMAIL ADDRESS*:

LEGAL BUSINESS NAME*:

DBA (IF APPLICABLE)

FEDERAL TAX ID (EIN)*:

ADDRESS (STREET, CITY, STATE, ZIP)

WEBSITE ADDRESS

NUMBER OF YEARS IN BUSINESS

Is current ownership the original ownership? If no, how many years has current ownership owned the business?*:

Are you a brick & mortar store, online store, or both?*:

If brick & mortar, how many locations?

What are the hours of operation?

State or Country of Incorporation*:

Business Type?*:

Has your business ever filed for bankruptcy?*:

Store Size in Sq. Ft. (If Applicable)

Number of Employees

Percentage of annual sales from ammunition or reloading supplies

Estimated annual sales of First Breach products (USD)

Submit documents per your state requirements. (Sales Tax License, Business License, and FFL)*:

Drop files here or

Max. file size: 50 MB.

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Consent

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Name

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