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Dealer Application Form

Company Name:

Owner/President:

Address:

Address:

City:

State:

Telephone:

Fax:

Email:

EIN/SSN:

Website: Optional

Relevant company history (duration of existence, law enforcement background, electronics experience):

Name and experience of all personnel who will install and service Prosecutor of Texas In Car Police Video System:

Describe your installation facility (size, location and other factors that make it suitable for installation and service of the Prosecutor product):

Current customer references (name, address and telephone number):

 

 

   
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