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Zamora Motors Pre-Qual Credentialing Form

Please fill out the info below.

Required Dealer Business Information

Dealer Business License Name (Legal) *

Additional Business Name (DBAs) *

Dealer Business Address *

Dealer Business City *

Dealer Business State *

Dealer Business Zip *

Dealer Business Number *

Required Dealer Signer Information

Signer Full Name *

Signer Title *

Signer Email *

Signer Phone Number *

Signer DOB *

Required Dealership and Signer Documents - [ Accepted file types: jpg, gif, png, pdf, Max. file size: 100 MB. ]

Please upload your Dealership's business license (not driver's license) *

Company Principal Information

Principal information will be used to ensure the Company meets Equifax’s credentialing requirements.
A principal is the company owner, founder, CEO, or a Senior Representative (CFO, General Manager, Director) at the company.

Principal’s First and Last Name *

Principal’s Email Address *

Principal’s Title *

Principal DOB – Not required upfront but may be requested in the future.

Dealership Website *

OfferLogix MCD Account Manager Name

OfferLogix MCD Account Manager Email

CRM Provider

Additional Dealer Access Information - (Not Required to Order)

CRM Email Address(es) for Sales Lead Routing

Usernames & Website Access

First Name & Last Name

Email Address

Cell Phone Number

First Name & Last Name

Email Address

Cell Phone Number

First Name & Last Name

Email Address

Cell Phone Number

First Name & Last Name

Email Address

Cell Phone Number

First Name & Last Name

Email Address

Cell Phone Number