Amsoil Retail Application

Once you download the Universal Sales Tax Certificate (G-495) tax exemption form and have completed it please email to RetailAccountApps@amsoil.com.

If you own a store with a retail storefront, quick lube shop, etc. and would like to sell Amsoil Products in your store please fill out the following form:

Amsoil Retail Account Application Form
* designates a required field.
Name of Business/Company*:
Purchasing Contact
First Name*:
Last Name*:
Phone*:
Fax:
Email*:
Accounts Payable Contact
Check box if same as purchasing contact.
First Name*:
Last Name*:
Phone*:
Fax:
Email*:
Does your company have a website?:
Billing Address
Street/PO Box:*:
City/Township:*:
State/Province*:
Zip/Postal Code:*:
Shipping Address
Check box if same as purchasing contact.
Note: Internet Explorer users must reselect "Shipping State below" manually or error will be received.
Street/PO Box:*:
City/Township:*:
State/Province*:
Zip/Postal Code:*:
Does this business operate out of a storefront with public access?:*:
Number of Stores/Outlets Operated/Owned?*:
Select Business Type:*:
Product to be used in business:
Motor Oils Four Stroke Oils Motorcycle Oils Suspension Fluids Diesel Oils Gear Lubricants Transmission Fluids 2 Cycle Oils	Greases Hydraulic Oils Compressor Fluids Air Filters and Oil Filters Power Sports Filtration Items Filtration By-Pass Equipment Fuel Additives Cleaners and Protectants
Any Other Amsoil Products sold?:
Associated Products sold by this business. Please include brand names*:
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