Request A Dealer Account Fill out the form with the correct information. A TRIMAX representative will contact you once the request has been reviewed. ALL fields in RED are required to complete the form.   Company Name: *   Business Type   Corporation Sole Proprietor Partnership Contact Person: *   Address: *   City: *   State: *   Zip: *   Phone: *   FAX: *   Resale Number: *   Type of Business: *   Date Business Established: *   E-Mail Address: *   Number of Employees: *   Website Address: *   DUNS Number: *