Read this application and shareholder agreement carefully before signing. Complete and check the Payment Option you elect. If the applicant is not accepted, the funds will be returned. Upon payment and acceptance, applicant will be issued One (1) Share of Class A stock, in accordance with the bylaws of the cooperative. Legal Name of Motor Vehicle Repair Facility*Facility Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Business Number*Cell Phone NumberShop EmailWebsite Address Federal Tax ID Number (EIN)(Required if partnership or corporation)Contact office for EIN Contact office for EIN Number of Facilities under same EIN or SSN #*Number of Body TechsNumber of Paint TechsShop's Square FootageAnnual Sales 500,000 - 1M 1M - 1.5M 1.5M - 2M 2.5M - 3М 3.5M - 4M 4.5M - 5M 5.5M - 6M 6.5M - 7M 7.5M - 8M 8.5M - 9M 9M - 10M 10M+ Brand of Paint(s) UsedPaint Type Waterborne Solvent-Based Estimating System Used Mitchell CCC ADP Manual Jobber/Supplier NameContact NamePhoneEmail Address Secondary Jobber/Supplier NameContact NamePhoneEmail Address Please mark what products or services you are currently using or interested in.I-CAR Organization ID #AkzoNobel (U.Tech, Lesonal, Sikkens) Currently Using Interested In Carborundum Currently Using Interested In Farecla Currently Using Interested In Norton Currently Using Interested In REVvive Currently Using Interested In All Clear Diagnsotics & Calibration Currently Using Interested In Adhesive Templates Currently Using Interested In American Brand Tape Currently Using Interested In asTech Currently Using Interested In Carparts Wholesale Currently Using Interested In Clarity Car Care Currently Using Interested In CrunchIT Financial Services Currently Using Interested In CTI-Collision Training Institute Currently Using Interested In DeVILBISS Currently Using Interested In E-Volve Currently Using Interested In Find Pigtails Currently Using Interested In Guardsman Auto Club Currently Using Interested In GUNI Currently Using Interested In Hendrick Chevrolet Currently Using Interested In Hertz Currently Using Interested In I-CAR Currently Using Interested In Kent Automotive Currently Using Interested In Lift King Currently Using Interested In OPUS-IVS Currently Using Interested In Performance Radiator Currently Using Interested In PMC Logic Currently Using Interested In Principled Payments Currently Using Interested In Production Board Currently Using Interested In S2F (Web Development) Currently Using Interested In Shawnee Mission Ford Currently Using Interested In Solera Currently Using Interested In SOLIDUS Currently Using Interested In Spanesi Currently Using Interested In SUN Currently Using Interested In Titanium Payments Currently Using Interested In T-Mobile Currently Using Interested In UniFirst Currently Using Interested In Wheel Restore Currently Using Interested In Please provide contact information below.Primary Contact Name* First Last Title*Email Address* Secondary Contact Name (if applicable) First Last TitleEmail Address Shareholder Agreement This agreement, the articles of incorporation and the bylaws, a copy of which I have received, constitute the entire contract and agreement between the shareholder and Collision Automotive Repair Services, Inc. and no offers, promises, representations, inducements, agreements or understandings of any kind shall be binding upon the cooperative. Upon acceptance of this application, in relation to Collision Automotive Repair Services, Inc. and under this agreement, I/we will be an independent contractor responsible for my/our own business and not an employee of CARS. I/we will be a shareholder of the cooperative and will not be treated as an employee in regard to any laws covering employees, including but not limited to the Federal Insurance Contributions Act, the Social Security Act, the Federal Unemployment Tax Act, income tax withholding at source, or any federal or state tax laws. I/we acknowledge that it is my/our responsibility to pay unemployment, franchise or sales tax and state and federal income taxes as required by law. A shareholder in Collision Automotive Repair Services, Inc. does not constitute a sale of a franchise or a distribution. This agreement is not intended and shall not be interpreted to create a relationship of agency, partnership or joint venture between any shareholder and the cooperative. Shareholders of Collision Automotive Repair Services, Inc. shall abide by any federal, state, county, and local laws or ordinances pertaining to this agreement and/or the sale, acquisitions, holding, distributing, servicing, or advertising of the products or services of CARS and at the shareholders own expense, they shall acquire any and all licenses or permits and file such reports as are required by law or lawful public authority with respect to this agreement. Shareholders are prohibited from making any representation or claim, verbal or written regarding Collision Automotive Repair Services, Inc. or any of its products, services or programs, other than those contained in material produced or approved by the cooperative. Shareholders of CARS may not use the name, logo or trademark of Collision Automotive Repair Services, Inc. without written approval. Any use of the name, Collision Automotive Repair Services, Inc. or CARS in any promotional material by shareholders of the cooperative must be accompanied by the words “shareholder of.” It is understood that upon notification to shareholders, Collision Automotive Repair Services, Inc. (CARS or Cooperative) may amend this shareholder agreement and the plans and policies of the cooperative and that the bylaws of CARS may be amended as provided therein. Stock Certificate issued upon payment and CARS Benefits begin on stock issue date.CARS Classic Purchase (One Time Purchase):*CARS Classic Fee Billing* Use Facility Address Enter a Different Billing Address Credit Card Cardholder Name Card Details Billing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Consent* I hereby apply to become a shareholder in Collision Automotive Repair Services, Inc. as a Class A shareholder. I hereby acknowledge that I have read and understand the shareholders agreement above. I hereby acknowledge that I have read the bylaws and articles of incorporation, and attest that I am of legal age in the state in which I enter into this agreement.Applicant’s Signature*Title if partnership or corporation*Date*
