TirePros Cancellation

To get started, please provide us with the requested information in this form. Once we receive your details, a member of our team will review them and get in touch with you shortly to discuss the next steps in the process. We look forward to working with you!

If you have any questions please email EnterpriseLaunch@connexVSC.com

Primary Contact Information

Name

First Name

Last Name

Title

Email

Phone

Best time to reach you?

Morning

Afternoon

Evening

Check all that apply.

IMPORTANT - If you have multiple locations, please fill out this form for each location!

Subform

Meineke Store Number

How many employees?

Address

Meineke Store Number

How many employees?

Address

Please download, complete, and then upload the following W9 form - click here to download

Please download, complete, and then upload the following ACH form - click here to download 

OR

Provide the account details where you'd like us to send ACH commissions. Please note - this account will only be used for deposits and will not incur any charges.

Account Number

Routing Number

I hereby authorize ConnexVSC and its administration company (“ConnexVSC”) to initiate direct deposits to the checking/savings account indiated above and to debit the same amount only for the purpose of reversing any error. This authorization will remain in full force and effect unless I notify ConnexVSC of any changes in writing.

Check this box if you accept the authorization

ACH Signature

Upload completed forms below

Upload Completed W9 form

Upload Completed ACH form here

A member of our team will be in touch shortly if you have any additional questions or comments!

Add your questions or comments:

Primary Contact Information

Alert

Please fill all the required fields.

OTP Verification

OTP Verification