Harley Davidson Licensee Form – Fill Out and Use This PDF

HARLEY-DAVIDSON MOTOR COMPANY

LICENSEE APPLICATION FORM

Return this completed form to licensingdept@harley-davidson.com or mail to Harley-Davidson Motor Company, Attn: Licensing Department/Application Form, 3700 W. Juneau Avenue, Milwaukee WI 53208

(Use the "tab" key to direct you to the next section)

COMPANY INFORMATION

Company Name:

Contact Person:

Title:

Principal Owner(s):

Title(s):

Address:

	City				State			Zip Code
Telephone:
Facsimile:
E-mail Address:
Web Site Address:
Number of Years in Business:
Number of Employees:
Total Annual Sales Volume (for current year):
Total Annual Sales Volume (for previous year):
What percentage of your overall sales is derived from licensed merchandise:						%
Privately Held Company (Y/N):				Publicly Held Company (Y/N):
Diverse business owner (Y/N):
If yes, please indicate the appropriate category
Class
Minority - MBE
Women - WBE
Both MWBE
Veteran/Service Disabled Veteran
Disabled

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Ethnic Origin

African American

Asian Indian American

Caucasian

Hispanic American

Native American

Certification Type

National Minority Supplier Diversity Council (NMSDC)

Women Business Enterprise National Council (WBENC)

Veteran

Please submit your certification

Description of Company:

PRODUCT INFORMATION

Briefly describe the product(s) for which you would like us to consider:

Does your company currently manufacture or sell the product(s) being submitted (Y/N):

DISTRIBUTION

TERRITORIES -- Check all territories that you currently sell to. For international markets, please list the specific countries within the territory that you currently sell to.

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RETAILERS -- List your top 10 accounts:

1)		2)
3)		4)
5)	6)
7)	8)
9)		10)

CHANNELS -- Identify below (check all boxes that apply) the channels of distribution you currently do business with and the corresponding percentage of your business.

LICENSING BUSINESS

Does your company currently manufacture products under licensing contracts (Y/N):

Specify what licenses your company currently holds and for how long:

1)

2)

3)

4)

5)

SALES FORCE / CUSTOMER SERVICE

Please identify how you service retail accounts:

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MANUFACTURING INFORMATION

Where will the products be manufactured (country of origin): Number of factories you currently do business with:

List the countries where you produce product in order of volume:

1)		2)
3)		4)
5)		6)
7)		8)
9)	10)

COMMENTS

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IMPORTANT

Please include with this form any, or all, of the following information you can provide to us electronically:

1)Annual Report

2)Sales catalogs, brochures, sell sheets

3)Articles (print and video) about your company

Legal Notice Regarding Proprietary Information:

Please note, it is the policy of Harley-Davidson's Licensing Department not to accept unsolicited submissions of creative ideas or materials. Accordingly, when you send us information about your company, do NOT include confidential or proprietary information, such as product concepts, designs, ideas, original artwork, or other original creative materials or suggestions. By not accepting any such unsolicited confidential or proprietary information, Harley-Davidson seeks to avoid possible future misunderstandings when products developed by our company or licensees might seem to others to be similar to their own creative work. You acknowledge and agree that Harley-Davidson at all times has many products and projects in various stages of development, and that the results of these endeavors may be similar or identical to your own products or projects.

If you ignore Harley-Davidson’s policy and submit any creative suggestions, ideas, notes, drawings, concepts, designs, original artwork, or other information (collectively, "Unsolicited Submissions"), The Unsolicited Submissions shall be deemed, and shall remain, the property of Harley-Davidson.

None of the Unsolicited Submissions shall be subject to any obligation of confidence on Harley-

Davidson’s part and Harley-Davidson shall not be liable for any use or disclosure of any Unsolicited

Submissions.

Yes, I have read the CONDITIONS FOR SUBMITTING A LICENSEE APPLICATION FORM to HARLEY-DAVIDSON MOTOR COMPANY (signature required):

Information Submitted By:

Signature:

Date:

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