Authorized Dealer Application Form

Verify that the information collected above is accurate and was collected in person. This is an Application for Dealership only. Piaggio Group Americas (PGA), does not assume any obligation or liability for any cost or expense incurred in preparing or submitting this application, nor for any liability or obligation contracted by any parties submitting this Application. All Applicants MUST BE APPROVED BY PGA and Sales and Service Agreements entered into and executed by both parties and delivered to you before a dealership relation can commence. All Agreements, orders or any document, paper, or instruments submitted with such Application shall not be binding upon PGA until Sales and Service Agreements are duly executed by both parties.