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Thank you for your inquiry in becoming an authorized Holloway account.

To initiate the process, please complete the following form making sure to include all information requested and signed with your electronic signature. Please note – some states require additional information to be submitted. Once the below form is submitted, please review the list of states to see if an additional form is required. If you have questions about this form or the process, please contact

Some states require us to have a copy of their state tax form on file. If you operate in one of the following states, please make sure we have the additional forms needed: Please complete and fax or email a signed copy to Holloway at: 937-497-8080 or (FL, LA, & MS forms are provided by your state)

Where applicable, we have provided links to the required state forms below: