The information below is submitted as an application for a Wheego Electric Cars (“WHEEGO”) Dealership. Submitting this application does not constitute acceptance or approval of the applicant nor in any way obligate Wheego Electric Cars, Inc., (“MANUFACTURER”) to enter into an agreement with the applicant.

To complete the data in the grey areas below, click on the area and type. See also the Help Text in the lower left-hand corner of the screen or with the cursor in a grey area, press F1.

APPLICANT

NAME IN FULL (First, Middle and Last): / HOME PHONE NUMBER: / BUSINESS PHONE NUMBER:
HOME ADDRESS (Street, City, State, Zip Code): / CELL PHONE NUMBER: / PRIMARY EMAIL ADDRESS:

PROPOSED AND / OR EXISTING BUSINESS NAME AND DEALERSHIP ADDRESS

BUSINESS NAME * / STREET ADDRESS / P.O. BOX (IF APPLICABLE) / CITY, STATE, ZIPCODE
BUSINESS PHONE NUMBER / BUSINESS FAX NUMBER / PRIMARY EMAIL ADDRESS / YEARS IN BUSINESS

* The “WHEEGO” trademark / name may not be used in the corporate name, but may be used as a DBA with prior written permission.

SOCIAL SECURITY NUMBER / FEDERAL TAX ID NUMBER

BANK REFERENCES

Contact Name: / Phone: / Email:
Bank Name and Location:

PROPOSED DEALERSHIP AND FACILITY

The proposed dealership entity will be (check one): Corporation Partnership Sole Proprietorship

Does the proposed / existing business have insurance coverage (check one)? Yes No

Is you business license to sell new vehicles in your state (check one)? Yes No

Payment method for inventory: Cash Floorplan (Floorplan source )

Will this facility be proposed as a dual or an exclusive WHEEGO facility (check one)? Exclusive Dual

If dual, what other brands will be represented?

PROPOSED INVESTMENT

Will funds for investment in the dealership, including working capital and inventories, be borrowed (check one)? Yes No

(If yes, please show detail in the STATEMENTS OF ASSETS AND SOURCE OF FUNDS section below.)

Do you currently have a floor plan source for inventory (check one)? Yes No If yes, please provide floor plan source and available credit line for inventory financing:

ASSETS AND SOURCE OF FUNDS TO BE UTILIZED IN THE DEALERSHIP

Below are the specific source of funds which I intend to utilize, if approved, for working capital and inventory financing.

DESCRIPTION OF EACH OF EACH PRINCIPAL ASSET / A
CURRENT VALUE PRIOR TO INVESTMENT / B
AMOUNT OF ENCUMBRANCES TO COLUMN (A) / C
NET AMOUNT TO BE INVESTED IN THE DEALERSHIP (A – B)
1. / $ / $ / $
2. / $ / $ / $
3. / $ / $ / $
4. / $ / $ / $
TOTAL ABOVE / $ / $ / $

By signing this application, permission is expressly granted to WHEEGO to verify the present status of the above listed information, including obtaining credit information and background checks. It may be necessary for WHEEGO to inquire, through outside sources, about applicant’s character and general reputation. The undersigned further agrees to the following:

WHEEGO shall keep confidential all financial information concerning the DEALER, its owner(s), related personnel and/or affiliates that may be disclosed in furtherance of the AGREEMENT, unless compelled to do so by law. Any misrepresentation, whether intentional or unintentional, in the information submitted in this application form or otherwise in connection with this application shall be grounds for immediate termination of the application process or any subsequent agreements.

The receipt, investigation and processing of this application by WHEEGO shall entail no commitment or liability whatsoever on the part of WHEEGO or any other entity, unless and until any such commitment is established through the execution of a formal Wheego Sales & Service Agreement by an Officer of WHEEGO. Any such commitment shall be limited to the express terms of such Wheego Sales & Service Agreement. Neither WHEEGO nor any other person affiliated with it shall have any responsibility whatsoever for any steps which the undersigned may take prior to the execution by WHEEGO of such Wheego Sales & Service Agreement in order to prepare for the operation of a WHEEGO dealership or in anticipation of such Wheego Sales & Service Agreement.

Any discussions I or my representatives may have with representatives of WHEEGO and any investigations or action taken by them with reference to the issuance of a Wheego Sales & Service Agreement do not in any way assure that I will be approved for ownership of a dealership or that any credit entity will make any loan to any such dealership managed or owned by me. Any actions I may take in expectation of being approved will be taken by me at my own risk and expense since any one or all of these possibilities may not occur.

IT IS UNDERSTOOD THAT ANY AGREEMENT ENTERED INTO BETWEEN APPLICANT AND WHEEGO IS NOT EFFECTIVE UNLESS AND UNTIL APPROVED AND SIGNED BY AN OFFICER OF WHEEGO.

Upon acceptance of your dealer application, please be prepared to provide the following items:

1) Photos of dealership facility and location.

2) Copy of dealership liability insurance.

3) Copy of current state New Car dealer license.

APPLICANT______

Print Name

______

Signature Date

Page 1 of 2