ATD Dealer Incentives Registration
Welcome to the ATD Dealer Incentives Registration portal.
Personal Information
* Required fields
The purpose of data collected on this website is to validate program guidelines, communicate with you about your request, facilitate any payment awarded and assess for potential duplicate and/or fraudulent submissions. As a service provider, we do not sell your information but we do share information with program owners and financial institutions.
SSN
First and Last Name must match legal name from Social Security Card.
First Name *
(max 25 characters)
Last Name *
(max 25 characters)
Mailing Address
(where reloadable card will be mailed)
Address *
PO Boxes are not accepted
Suite/Apt#
Postal Code *
City *
State / Province *
select
Select One
AL - Alabama
AK - Alaska
AZ - Arizona
AR - Arkansas
AE - Armed Forces
CA - California
CO - Colorado
CT - Connecticut
DE - Delaware
DC - District of Columbia
FL - Florida
GA - Georgia
GU - Guam
HI - Hawaii
ID - Idaho
IL - Illinois
IN - Indiana
IA - Iowa
KS - Kansas
KY - Kentucky
LA - Louisiana
ME - Maine
MD - Maryland
MA - Massachusetts
MI - Michigan
MN - Minnesota
MS - Mississippi
MO - Missouri
MT - Montana
NE - Nebraska
NV - Nevada
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NY - New York
NC - North Carolina
ND - North Dakota
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
PR - Puerto Rico
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VT - Vermont
VI - Virgin Island
VA - Virginia
WA - Washington
WV - West Virginia
WI - Wisconsin
WY - Wyoming
Your Email Address *
Email address is invalid. Format is:
[email protected]
*All information will be verified by the IRS and failing to supply correct information will result in non-payment until corrected information is entered.
Next
Confirmation
Account and all locations under it have been set as NOT APPROVED to participate in the ATD Reloadable Debit Card program.
You can always come back and 'APPROVE' at any time.
There was an error during the submission.
Ensure all fields are accurate and please try again.
OK
Registration Successful!
You have successfully registered on the ATD Dealer Incentives portal.
If you have any questions about the ATD Dealer Incentives program, please contact your ATD representative.
There was an error saving your registration information.
Ensure all fields are accurate and please try again.
OK
Confirmation Number Request
Please enter the following information and click submit.
An email request for the confirmation number will be sent to the dealership's principal owner.
Your First Name *
(max 25 characters)
Your Last Name *
(max 25 characters)
Your Email Address *
Your Phone Number *
Submit Request
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