Become A Dealer

Take the first step toward becoming an authorized LEED Brakes dealer. Fill out this brief form and we'll have a representative contact you within 24-48 hours.

All information provided will remain confidential as we do not sell or distribute any customer information without your consent.

Please email a copy of your business license and tax id to info@leedbrakes.com

Billing Address

Business Name

Billing Address Line 1 *

Billing Address Line 2

Billing City *

Billing State *

Billing Zip / Postal Code *

Business Phone # *

Primary Contact Name *

Primary Email *

Primary Contact Phone # *

Shipping Address - if different than billing address

Business Name

Shipping Address Line 1

Shipping Address Line 2

City

State

Zip/Postal Code

Were you helped by a LEED Brakes Representative?

Sales Representative:

How did you hear about LEED Brakes? *

Tax Information

Exempt from sales tax? *

Sales Tax County

Sales Tax ID Number

Contact Information - Complete all that apply

Purchasing Contact Name

Purchasing Contact Email

Purchasing Contact Phone

Accounting Contact Name

Accounting Contact Email

Accounting Contact Phone

Marketing Contact Name

Marketing Contact Email

Marketing Contact Phone