InterActive® for Suppliers

Dealership Security/Profile Set-up
(* = Required Field)
Profile     Primary Contact  
Dealership Name:*   Name:*  
Legal Business Name:*   Phone:*  
Type of Business:*   Fax:  
Doing Business As:*   Email:*  
Federal ID Number:*   Mobile/Pager:  
Address 1:*   Preferred Contact Method:*  
Address 2:        
City:*   Secondary Contact  
State:*   Name:*  
Zip:*   Phone:*  
Country:*   Fax:  
Phone:*   Email:*  
Fax:   Mobile/Pager:  
Website:   Preferred Contact Method:*  
Manufacturer:*        
Manufacturer Dlr #:*   General Manager  
BAC #(GM Only):   Name:*  
BFC #(GM Only):   Phone:*  
Door to Door Capability:   Fax:  
Title & Registration Capability:*   Email:  
Element Fleet Vehicle Capacity:*   Mobile/Pager:  
Mother's Maiden Name:*   Preferred Contact Method:*  
 
ELECTRONIC PAYMENT INFORMATION  
Bank Information  
Please enter the required fields if you will be using the electronic payment option  
 
Bank Name:*  
Address 1:*  
Address 2:  
City:*  
State:*  
Zip:*  
Country:*  
Dealer Representative:*  
Account Number:*  
ABA Number:*  
Account Type:*  
Bank Code:*