3776 S.R. 93 N.E., Crooksville, OH Toll Free (866) * Phone (740) * Fax (740)
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1 3776 S.R. 93 N.E., Crooksville, OH Toll Free (866) * Phone (740) * Fax (740)
2 Name of Dealer: Telephone ( ) (Legal Name if Different) Fax# ( ) (Hereinafter Referred to as Dealer) Address: City ST. Zip BUSINESS INFORMATION Is the Dealer: An Individual Partnership Corporation LLC Federal Tax ID# If Registered with AuctionAccess, please provide Dealership # Individual # When was Dealer Organized? / / Dealer License # Sales Tax # Do you expect to Buy Sell If you expect to buy, will you use: Cash Checks Drafts (Subject to Auction Approval) Type of Dealer: Franchised Used Wholesale Retail If Franchised, Make of Car Sold: *Auction and its insurers are authorized to investigate the history of Dealer and any of Dealer's Owner and Officers through banks, financial institutions, credit reporting agencies and other sources. YES NO List of Owners and Officers Name Title SSN Home Address Phone U.S. Citizen? Yes No Name Title SSN Home Address Phone U.S. Citizen? Yes No Name Title SSN Home Address Phone U.S. Citizen? Yes No CREDIT INFORMATION Bank Address Name of Official Account # Credit or Float Plan Limit How Long Doing Business? Finance Company Finance Company Address Name of Official Credit or Floor Plan Limit $ How Long Doing Business? *If you have done business with either of the above for less than 3 years, give previous financial institution(s) name and address. Bank Finance Company Address Address The information above is accurate. Dealer agrees to Auction's Rules & Regulations. /s/ Date Title
3 Dealer Name: Owner: Telephone: ( ) Address: Fax#: ( ) Dealer License#: Expiration Date: / / Federal ID#: Resale Tax#: BUSINESS TYPE Corporation Sole Proprietorship LLC Partnership AuctionAccess#: TYPE: Bank Franchise Government Independent Fleet/Lease Rental Salvage Wholesale Factory Bank Name: Contact: Branch Name: Address: City: State: Zip: Phone Number: ( ) Account Number:
4 Authorized Buyer Form (pg. l of 2) Please check one choice below: ADD CHANGE REMOVE :Authorized Buyer Dealer Name: Address: City ST Zip Phone Number: ( ) Authorized Buyer Name (Please Print): Authorized Buyer's Phone Number: ******** I,, represent I am the named account holder and authorize Value Auto Auction to add/remove/change the above person as an authorized buyer on this account as indicated above, subject to the terms on page 2 of this form.********* Printed Account Holder's Name: Date: Signature of Account Holder: Date: *By designating an authorized user on this account(s), you are granting permission for this person to access and/or make changes to your account(s). **By removing the authorized buyer on the account(s), you are revoking permission for this person to access and/or make changes to your Value Auto Auction account(s). ***You may be contacted should we have any questions regarding this form
5 References: Other Auctions You Attend: Other Auctions You Attend: Dealer or Other Business Reference: Authorized Representatives: Authorized Buyer Form (pg. 2 of 2) How Long Registered? How Long Registered? Telephone: The following person(s) are duly authorized to buy and sell automobiles, to execute checks or drafts, to execute bills of sales, assignments of titles and warranties of titles on behalf of Dealer. The authority of the following person(s) to act on behalf of the Dealer shall continue in full force and effect until terminated by Dealer in writing to the Auction. Dealer does hereby guarantee all transactions made by such person(s). Representative: Signature: SS#: DOB: / / Phone # Authorized to sell cars? YES NO Authorized to sign checks? YES NO Account Holder's Signature: Authorized to sign drafts? YES NO Date: / / Representative: Signature: SS#: DOB: / / Phone # Authorized to sell cars? YES NO Authorized to sign checks? YES NO Account Holder's Signature: Authorized to sign drafts? YES NO Date: / / Phone # Representative: Signature: SS#: DOB: / / Phone # Authorized to sell cars? YES NO Authorized to sign checks? YES NO Account Holder's Signature: Authorized to sign drafts? YES NO Date: / / Phone # GUARANTY In consideration of Auction allowing Dealer to buy and sell motor vehicles through Auction, the undersigned, whether one or more, personally covenant, guarantee and warrant the title to each vehicle sold by Dealer through Auction will be good and will be free and clear of all liens and encumbrances, whatsoever. The undersigned unconditionally agrees to reimburse Auction for any loss, damage, expense, or costs, including attorney's fees, incurred by Auction as a result of breach of the foregoing warranty of title as to any such motor vehicle. The undersigned further personally guarantees full payment of any debts of Dealer to Auction, including any checks or drafts issued by Dealer or any of Dealer's representatives, together with any loss or expense incurred by Auction in collecting or attempting to collect such debt, including attorney's fees. The undersigned acknowledges that Auction shall have the right to refuse to transact business with Dealer or the undersigned, to modify or release any and all collateral security, to extend or change time of payment and to settle or compromise with Dealer without notice to the undersigned and without discharging or affecting the liability of the undersigned hereunder. This guaranty is to be a continuing guaranty and the undersigned hereby waives notice of acceptance of this guaranty and presentment, demand, protest, and any notice of non-payment or dishonor. The undersigned shall be liable as principal debtor and not merely as surety, and the bankruptcy or any assignment in favor of Creditors of Dealer shall not affect the enforceability of this agreement. Auction's impairment of any security for Dealer's obligations shall not discharge in whole or in part this guarantee. This instrument shall bind the respective heirs, executors and administrators, and assigns of the undersigned, and shall inure to the benefit of Auction, its successors, assigns, and subrogees. Where there is more than one signatory to this agreement each signatory shall be jointly and severally liable under the agreement. IN WITNESS WHEREOF the undersigned have hereunto set their hands and seals this Day of, 20. WITNESS WITNESS WITNESS
6 Dealer Name: Date: / / Bank Name: Account Number: Bank Address: City ST Zip Bank Phone: ( ) Bank Fax: ( ) To Whom it May Concern: I have listed your financial institution as Dealer's principal banking reference for Value Auto Auction (VAA). VAA is a wholesale vehicle auction for licensed new and used motor vehicle dealers and repossessed vehicles. I authorize the release of the information requested below. This data is for VAA's internal purposes only and will be kept strictly confidential. Your prompt reply is appreciated. If you have any questions, please feel free to contact VAA by phone, fax, or listed at the top of this page. I hereby grant my ongoing written consent to VAA to run a credit check and obtain a credit report, consumer report, or investigative consumer report from any source on my dealership and me personally. I also give consent to the bank listed above to release Dealer's credit information to VAA. Any charges associated with these services should be billed directly to me, the account holder. Regards, Authorized Printed Name: Authorized Signature: Checking Account: OPEN DATE AVERAGE BALANCE CURRENT BALANCE RELATIONSHIP Other Accounts OPEN DATE TYPE AVERAGE BALANCE CURRENT BALANCE RELATIONSHIP Number of Returned Checks: Line of Credit: Available Balance: Banker's Signature: Title: Printed Name: Date: / /
7 Commercial Blanket Power of Attorney Company Name: Date: / / While transacting business with the Value Auto Auction LLC. in Crooksville, Ohio, I hereby appoint the following company representative(s) as my attorney in fact to sign all motor vehicle documents relating to title and registration transactions for said company. Value Auto Auction Representatives Form remains on file with Value Auto Auction LLC until withdrawn or a replacement form is provided by the company. A replacement form is the company's sole responsibility and must be resubmitted when changes to this authorization are desired. Company Name: Printed Name: Signature: Owner President Vice President Other: Address: City: State Zip Business: Phone Number: ( ) State of Ohio Personally appeared before me, the undersigned authority, with whom I am personally acquainted, who acknowledged that the foregoing instrument was executed for the purpose therein contained, on this day of,. Day Month Year Notary Public SS: My Commission Expires: / /
8 FAX CONSENT FORM In order for Value Auto Auction to be compliant with the recent Federal Communication Commission regulations, we must obtain expressed written consent from our customers and business partners in order to call and transmit faxes and/or s. Please have the appropriate person in your company fill out this form and fax it back to us as soon as possible. Thank you for your continue business with us. Company/Organization for which consent is being provided: Name of person authorized to give such consent: Phone number(s) for which this consent is being provided: Fax number(s) for which this consent is being provided: s for which this consent is being provided: I understand that by providing the fax number(s) and or (s) above on behalf of the customer/business partner specified above, I am authorized to and hereby consent for the customer/business partner to receive faxes and s sent by, or on behalf of Value Auto Auction. SIGNATURE: DATE: / /
9 ("Dealer") [Dealer Name] PERSONAL GUARANTY In consideration of Auction allowing Dealer to buy and sell motor vehicles through Auction, the undersigned whether one or more, personally covenants, guarantees and warrants the title of each vehicle sold by Dealer through Auction will be valid and will be free and clear of all liens and encumbrances, whatsoever. The undersigned unconditionally agrees to reimburse Auction for any losses, damages, expenses or costs, including attorney's fees, incurred by Auction as a result of any breach of the foregoing warranty of title as to any such motor vehicle. The undersigned further guarantees full payment of Dealer's debts to Auction, including any checks or drafts issued by Dealer or any of Dealer's representatives, together with any losses or expenses incurred by Auction in collecting or attempting to collect such debt, including attorney's fees. The undersigned further personally guarantees the Odometer Mileage Statements given by or on behalf of the Dealer in all sales of motor vehicles by Dealer through Auction, and agrees to indemnify and hold harmless the Auction from all losses and expenses caused it by any such Odometer Mileage Statement including without limitation: (1) payments made by the auction under any Odometer Protection Program it may establish in connection with any vehicle sale, (2) any amount paid in settlement of any claim in connection with any such odometer complaint or problem (3) any amounts paid as damages for any odometer claim, including any punitive damages, and (4) any expense or costs incurred by Auction in defending any odometer claims in connection with Dealer's sales or collecting or attempting to collect any losses, including attorney's fees. The undersigned acknowledges that Auction shall have the right to refuse to transact business with the Dealer or the undersigned, to modify, extend or change time of payment to settle with Dealer, to release any and all collateral or security, without notice to the undersigned and without discharging or affecting the liability of the undersigned herein. This guaranty is to be a continuing guaranty and the undersigned hereby waives notice of acceptance of this guaranty, presentment, demand, and not merely as surety, and the bankruptcy or any assignment in favor of the Creditors of Dealer shall not affect the enforceability of this agreement, Auction's impairment of any security or collateral to Dealer's obligation shall not discharge, in whole or in part, this guarantee. This Guaranty shall hind the respective heirs, executors, administrators, and assigns of the undersigned, and shall inure the benefit of the Auction, its successors, assigns and subrogees. Where there is more than one signatory to this agreement, each signatory agrees to be jointly and severally liable under this agreement. GUARANTOR: (Print) (Sign) GUARANTOR: (Print) (Sign) GUARANTOR: (Print) (Sign) DATE: / /
10 Value Auto Auction Is the Fastest Growing Auto Auction in the Midwest
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