Dealer Municipal Credit Claim

This form may be used for stock sales that you have made to Municipalities and did not previously get the Municipality Bid Discount.

Municipal Credit Form (20240223)

This is the Municipal Credit Form

"*" indicates required fields

1Authorized Dealer

2Product Details

Municipality Invoice*

Upload your invoice to the Municipality.

Max. file size: 50 MB.

Please complete the following details about the Authorized Dealer and Municipality who has purchased the Switch-N-Go Products, followed by the what products where sold.

Submission Date

SUBMISSION DATE

Salesperson Information

Please complete the following details about the Authorized Dealer Salesperson

Dealer Sales Person*

First Name* Last Name*

Dealer Company Name

COMPANY NAME*

Dealer Contact Email*

CONTACT EMAIL*

Dealer Phone Number*

CONTACT PHONE*

Customer Information

Municipality Name*

Municipality NAME*

Municipality Contact Email

CONTACT EMAIL

Municipality Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What is the product?

Total of Hoist Systems

Total of Truck Bodies

MN Hoist System 01*

Model Name

SN Hoist System 01*

Serial Number

MN Hoist System 02*

Model Name

SN Hoist System 02*

Serial Number

MN Hoist System 03*

Model Name

SN Hoist System 03*

Serial Number

MN Truck Body 01*

Model Name

SN Truck Body 01*

Serial Number

MN Truck Body 02*

Model Name

SN Truck Body 02*

Serial Number

MN Truck Body 03*

Model Name

SN Truck Body 03*

Serial Number

MN Truck Body 04*

Model Name

SN Truck Body 04*

Serial Number

MN Truck Body 05*

Model Name

SN Truck Body 05*

Serial Number

MN Truck Body 06*

Model Name

SN Truck Body 06*

Serial Number

MN Truck Body 07*

Model Name

SN Truck Body 07*

Serial Number

MN Truck Body 08*

Model Name

SN Truck Body 08*

Serial Number

MN Truck Body 09*

Model Name

SN Truck Body 09*

Serial Number

MN Truck Body 10*

Model Name

SN Truck Body 10*

Serial Number

Name

This field is for validation purposes and should be left unchanged.

Dealer Municipal Credit Claim

Municipal Credit Form (20240223)

Salesperson Information

Customer Information

What is the product?

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Josh Oertly

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"" indicates required fields

Email Recipient
Josh Oertly
Name
First Last
Company Name
Email*

Phone
Message*
Comments
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