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" indicates required fields
Step
1
of
7
14%
Are you ready to REVolutionize your dealership?
Todays date:
How did you find out about us?
*
I was referred by a mutual connection
I found you online
I've been working with a Rev team member
I wish to sign up with:
*
Endurance
Veritas
Please select ALL the boxes of the providers you'd like to sign with
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Service Contracts
Vertias Guard
Veritas Simplicity
Veritas EV
Veritas Exotic
Veritas Essentials
Veritas Select
Veritas Rec (RV program)
Veritas Sport (Powersports)
You will be set up with VSC by default.
This field is hidden when viewing the form
Ancillary Products
Tire and Wheel
5 in 1
Theft
Who Referred You?
*
First
Last
Email
*
Rev Team Member
*
-
Nick Terry
Riley Schroeder
Lyle Starr
Other
Your Dealership:
Dealership Name
*
Main Phone
*
Website
*
Address
*
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Does this Dealership have more than one location?
Yes
No
Location #2 Name
*
Location #2 Phone
*
Address
*
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Dealership is:
Independent
Franchise
Dealership is:
Independent Group
Franchise Group
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Dealership is:
Independent
Independent Group
Franchise
Franchise Group
Years in Business
*
Select your DMS (Dealer Management System)
*
CDK
DealerTrack
Reynolds & Reynolds
Other
"Other" DMS
*
Do you have an E-Rater/Menu provider?
*
Yes
No
E-Rater/Menu Company
*
Do you offer BHPH Financing?
Yes
No
Do you offer Vehicles with Salavaged Titles?
Yes
No
Set up direct deposit for Veritas Paylink Direct/ Endurance ACH Dealer Over Remit?
*
Yes - Set me up now
No - I'll set that up later
Do you have a shop?
Yes
No
Set up as Preferred Repair Facility?
Yes
No
Service Manager
*
First
Last
Email
*
Phone
*
Allow MSRP for Parts?
*
Yes - increase our rates accordingly
No, cost for parts is sufficient
MSRP Rate increase is volume based, $50 - $150 per contract
Posted Labor Rate
*
Labor time guide used:
*
Labor Tax %
*
Please do not use the % sign at the end of the number
Part Tax %
*
Please do not use the % sign at the end of the number
Add Additional Diag time?
Yes - increase our rates accordingly
No, the covered 30 minutes is sufficient
How much time is needed to diag in each claim?
Veritas coveres 30 minutes of diag time per claim. If more time is required, indicate a number in hours above. A small rate adjustment will apply ($50-$100 per contract)
Basic Sales Info
Average Monthly New Vehicle Sales
*
Average Monthly Used Vehicle Sales
*
Average Monthly Vehicle Sales
*
Average Monthly VSC Sales
*
Expected Monthly VSC Sales
*
Expected Monthly ANC Sales
*
Per Vehicle Retail
*
Average amount spent reconditioning per unit
*
Asian Inventory
*
0% - 10%
11% - 33%
34% - 50%
51% +
Domestic Inventory
*
0% - 10%
11% - 33%
34% - 50%
51% +
European Inventory
*
0% - 10%
11% - 33%
34% - 50%
51% +
0-80K Miles Inventory
*
0% - 10%
11% - 33%
34% - 50%
51% +
80K-125K Miles Inventory
*
0% - 10%
11% - 33%
34% - 50%
51% +
125K-200K Miles Inventory
*
0% - 10%
11% - 33%
34% - 50%
51% +
Service Contract Success Rate
*
0% - 10%
11% - 33%
34% - 50%
51% +
GAP Contract Success Rate
*
0% - 10%
11% - 33%
34% - 50%
51% +
Theft Program Success Rate
*
0% - 10%
11% - 33%
34% - 50%
51% +
Sales Tax Certificate
Sales Tax Certificate
Drop files here or
Select files
Max. file size: 4 GB.
Your state requires EDS to have a sales certificate on file.
Ownership Details
Dealer Entity Type
*
-
Individual/sole proprietor or single-member LLC
C Corporation
S Corporation
Partnership
Trust/Estate
LLC
LLC Type
*
-
LLC-P
LLC-C
LLC-S
Dealer EIN
*
How Many Owners are there?
*
One
Two
Three or more
State License #
Dealership DBA
Owner 1 Details
Owner 1
*
First
Last
Email
*
Phone
*
Title
*
Equity Share %
*
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Is also:
General Manager
Sales Manager
Finance Manager
Accounts Payable
Owner 2 details
Owner 2
*
First
Last
Email
Phone
Title
Equity Share
*
1
2
3
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Owner 3 Details
Owner 3
*
First
Last
Email
Phone
Title
Equity Share
*
1
2
3
4
5
6
7
8
9
10
11
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100
Your Team
1. Don't have the role? Put N/A instead. 2. Please Provide at least 2 unique contacts in order for Paylink to be approved.
General Manager
*
First
Last
Email
*
Phone
*
Sales Manager
*
First
Last
Email
*
Phone
*
Finance Manager
*
First
Last
Email
*
Phone
*
Accounts Payable
*
First
Last
Email
*
Phone
*
Other (for Paylink)
First
Last
Email
Phone
There must be a unique contact for Paylink approval. Please enter a unique contact in the "Other (for Paylink)" section.
Who is the signer?
Owner
General Manager
Sales Manager
Finance Manager
Other Authorized Signer
My Specific Role
*
You chose "Other Authorized Signer." Tell us more about role and responsibilities at the dealership.
Dealer VSC Rate Adjustment Breakdown
Retail Markup
*
Yes
No
Retail Markup 3 Month:
Retail Markup 6 Month:
Retail Markup 12+ Month:
Retail Markup for GAP
Dealer Pack
*
Yes
No
Dealer Pack 3 Month:
Dealer Pack 6 Month:
Dealer Pack 12+ Month:
Dealer Pack Markup for GAP
Dealer Over Remit **
*
Yes
No
**Additional Dealer Over Remit Information:
W9(s) required for all Dealer Over Remits. Over Remit checks are sent monthly to Payee, based on previous months' fully funded contracts. All Over Remits are subject to Chargebacks.
How many Payees?
1
2
3
Payee 1 Name
First
Last
Payee 1, 3 month
Payee 1, 6 month
Payee 1, 12 month
Payee 1, GAP
Payee 2 Name
First
Last
Payee 2, 3 month
Payee 2, 6 month
Payee 2, 12 month
Payee 2, GAP
Payee 3 Name
First
Last
Payee 3, 3 month
Payee 3, 6 month
Payee 3, 12 month
Upload Payee W9(s)**
*
Drop files here or
Select files
Max. file size: 4 GB.
Download blank W9 forms
here
, then come back and upload them above.
Banking info
Lender Information
Please list the lenders your finance department utilizes to ensure the correct forms are set up for eContracting at your dealership. Identifying all captive lenders is crucial, as any omissions may lead to funding delays or rejections.
Ally
Chase
Wells Fargo
Cyprus Credit Union
Mountain America Credit Union
America First Federal Credit Union
Other
"Other" Lender Name
Set up direct deposit for Veritas Paylink Direct/ Endurance ACH Dealer Over Remit?
*
Yes - Set me up now
No - I'll set that up later
Bank Name
*
Routing Number
*
0 of 9 max characters
Account Number
*
Account Type
*
Checking
Savings
Banker Name
*
First
Last
Bank Employee Phone
*
This field is hidden when viewing the form
Dealer Bank Contact Title
Bank Address
*
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Copy of Voided Check
*
Drop files here or
Select files
Max. file size: 4 GB.
Signer Agreements
My Name
*
First
Last
Email
*
Phone
*
My Role
*
Owner
General Manager
Sales Manager
Finance Manager
Other Authorized Signer
Day
Month
Year
*
Veritas Dealer Agreement - VSC
*
Veritas Dealer Agreement - Service Contracts
*
I accept the Veritas Dealer Agreement - Service Contracts
terms and services
Veritas Branded Title/Lemon Law
*
Veritas Branded Title / Lemon Law Addendum
*
I accept the Veritas Branded Title / Lemon Law Addendum
terms and services
Veritas Dealer Agreement-GAP
*
Veritas Dealer Agreement - (GAP) Guaranteed Asset Protection
*
I accept the Veritas Dealer Agreement - Guaranteed Asset Protection
terms and services
AAPI Dealer Marketing
*
APPI Dealer Marketing and Administration Agreement
*
I accept the APPI Dealer Marketing and Administration Agreement
terms and services
Paylink Direct
*
Paylink Direct - Dealership Agreement
*
I accept the Paylink Direct Dealership Agreement
terms and services
Veritas Dealer Agreement - VSC
*
Endurance Dealer Agreement - Service Contracts
*
I accept the Endurance Dealer Agreement - Service Contracts
terms and services
Veritas Dealer Agreement - VSC
*
Endurance Dealer Agreement - (GAP) Guaranteed Asset Protection
*
I accept the Endurance Dealer Agreement - (GAP) Guaranteed Asset Protection
terms and services
Veritas Dealer Agreement - VSC
*
Endurance Dealer Agreement - GAP Rate Adjustments
*
I accept the Endurance Dealer Agreement - GAP Rate Adjustments
terms and services
Electronic Signature Consent
*
Electronic Signature Consent
I accept the Electronic Signature Consent
terms and services
Opt-in to digital marketing
yes
No
Consent to receive marketing texts and emails from Rev Dealer Resources
Dealer Representative Sign here:
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