tiCity
Application Form "Submit" to us online or fax this page to us to quickly process the setup.
You must then mail the completed signed original Application and Agreement to receive any compensation. Mail both pages  with payment to address below.
Elect 
Dealer
Service

Current 
Comp. Plan
40
20
10
----
10

. Service Invest L1 Level 3 GetFree Description
tiFundRaiser
$0
na
na
ON-GOING rebates 40% of referrals sales and renewals
tiStation/Pro
$0
$75
0, 3B/3P
Dealer Staion. Eligible for multiple referrals and programs
tiStore
na
$398
20B/20P
+$69-Month. Your ZipCode.com company assigned server
tiFRaiser: Setup your account and maintain for one year. Receive sales commissions on Rebee™ products
tiStation:Setup your account and maintain for one year. Receive sales commissions on Rebee™ products
tiStore: Setup your account and maintain for one year. Receive DEFAULT sales commissions on all your Zip code area
<-- Please enter record ID number of person that refer you to us.

Dealer Information

SS # is required to pay you rebates

Your entry must match the name and address on your credit card.

First name
Last name
Bus. Organization
Payto: SS or Fed ID
Email address
Web addr. URL if any
Street address
City
State
Zip/Postal
Phone (with AC) 
Fax

Payment Information
All of your payment information is kept strictly confidential

Expire
Check or Money Order: Make checks and money orders payable to TimcoUSA. Preferred payment method: Automatic Credit Card Debit I (We) hereby authorized TimcoUSA, hereafter referred as "Seller", to initiate debit entries (withdrawals) to my accounts as indicated and Credit Card Companies to debit the same to such accounts. This authority is to remain in full force and effect until "Seller" and Credit Card Companies have received written notice from me (or either of us) of its termination in such manner as to afford "Seller" and Credit Card Companies a reasonable opportunity to act upon it. 
Print & Fax 361/668-0036
or Mail with payment to:----->
---OR Email ------>
 TimcoUSA
Regional office
427 So. Reynolds St.
Alice, Texas 78332
If you prefer you can email this form here 
this is a secured site. Just press submit
Submitting this form means that you agree with Timco terms and conditions
I agree to comply with all the terms and conditions listed on page 2 of this agreement.
I understand that I have the right to terminate my Dealership business at any time with or without reason. I understand and agree that this agreement does not constitute the sale of a Franchise or Dealership and that there are no exclusive territories granted or guarantee to me 

YOUR SIGNATURE :_______________________________      Date ___________________________



Corporations only, complete the following: 1) State of incorporation _________.  Attach a list of Names and Social Security numbers of all shareholders, directors and officers.
2) Resolve that ______________________ (name of corporation) is authorized to enter into a Timco Dealership application and agreement with Timco and to execute all and any documents necessary to conduct business with Timco. We certified that this resolution was adopted by the Board of Directors of ______________________ (name of corporation) on ______________ (date) at a meeting of the Directors of this corporation properly called, and shall continue in effect rescinded by resolution duly adopted by the Board of Directors of this corporation, notice of which shall be signed by the President of this Corporation and provide to Timco . Each shareholder, director, and officer acknowledges that, in addition to the obligations and responsibilities of the corporation, they are personally and individually bound to and must comply with the terms and conditions of the Dealership Application and Agreement, Policies and Procedures, and the Compensation Plan.

President     ____________________________             Secretary   _______________________________________      Date ________________________ 

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