Distributor Login
ProductsDistributor SignupcarriersAlliancesAbout UsMore Info
DEALER SIGNUP
Dealer Application - Welcome, GPA is your partner in selling prepaid.
ACCOUNT (DEALER) INFORMATION
 
Dealer Name:
Type of Business:
Years in Business:
 
(Contact Name)First: Last:
 
Email Address:
Primary Phone:
 
Alternate Phone:
Fax Number:
 
(Mailing Address)Street Address:
 
City:
State:
Zip:
 
Company DBA (if applicable):
 
Company Web Address (if applicable):
 
PERSONAL GUARANTY
 

In order to induce GPA to enter into this Agreement, I/we, the Guarantor(s), do hereby unconditionally guarantee the due and punctual payment, performance, and discharge when and as the same shall become due of all obligations of the Dealer to GPA under this Agreement, together with interest thereon at the rate set forth in this Agreement and all expenses incurred by GPA in connection with the collection from Dealer or me, of the obligations created by this Agreement, including, without limitation, reasonable attorney's fees, expenses and costs.  The Guaranty is a primary and original obligation and is an absolute, unconditional, and continuing guaranty of payment and performance and shall remain in full force and effect until revoked in writing by me, but such revocation shall not affect my obligation with respect to any of the obligations existing at the time of receipt by GPA of my revocation If there is more than one Guarantor, each such Guarantor shall be jointly and severally liable.  GPA may proceed against any Guarantor with or without joining or first proceeding against the Dealer entity or any other persons or Guarantors. I, the undersigned guarantor, hereby authorize GPA to investigate my personal credit standing, financial circumstances, and responsibility, and specifically authorize GPA to obtain consumer reports and all other relevant reports for making such investigation.   This authorization relates to the purchase and processing of prepaid products and services.  I understand that without this authorization GPA may not be entitled to obtain this information.

 
Owner Name:
(typed name constitutes original signature)
Guarantor Name:
(typed name constitutes original signature)
Date:
Date:
 
PAYMENT METHOD
 
AUTHORIZATION FOR EFT ACH PAYMENTS
DEALER hereby authorizes GPA, Inc. ("GPA") to initiate debit entries to its:
 
Business Account Personal Account     (please check one)
 
Checking Account Savings Account     (please check one)
 

The account number of which is indicated below at the depository financial institution named below (the "Depository"), and to debit amounts to such account. GPA acknowledges that the origination of ACH transaction to its account must comply with the provisions of U.S. law.

 
Depository Name (Bank):
Branch:
 
Bank Branch Phone Number:
 
(Bank Mailing Address)Street Address:
 
City:
State:
Zip:
 
Routing Number:
Account Number:
 

This authorization is to remain in effect until GPA has received written notification from the Company of its termination in such time and in such manner as to afford GPA and the Depository a reasonable opportunity to act on it (a minimum of 14 days).

 
Authorized Name:
(typed name constitutes original signature)
Date:
 
I have read and accept the terms and conditions listed here
 
Enter the text Below:
 
 
 
Back to GPA Homepage Copyright 2010 GPA, Inc. All Right Reserved
http://www.gpa.net