For Dealers

Pakedge Dealer Application

Please complete the entire application and submit the required documents below. For fields that do not apply, please specify "N/A."

Resale Certificate: [] Click to upload Our company DOES NOT have a Resale Certificate
Business License: [] Click to upload Our company DOES NOT have a Business License

COMPANY DETAILS
Company Name	Related DBAs	Website	D&B Number

Select One: Sole Proprietorship Partnership C Corporation S Corporation

OWNER INFORMATION
Salutation	First Name	Last Name	Title	Email	Phone

PRIMARY BILLING ADDRESS
Street Address	City	State	Zip	Country	Phone	Fax

PRIMARY SHIPPING ADDRESS Same as Billing Address
Street Address	City	State	Zip	Country	Phone	Fax

NOTE: Orders will not be shipped to P.O. Boxes

AUTHORIZED PURCHASING CONTACT Same as Owner
Salutation	First Name	Last Name	Title	Email	Phone

NOTE: For security reasons, each dealer is permitted to register ONE purchasing contact. The email address provided in this section will be the ONLY email address with access to the Pakedge Web Store.

ACCOUNTS PAYABLE CONTACT Same as Owner Same as Authorized Purchasing Contact
Salutation	First Name	Last Name	Title	Email	Phone

NOTE: All invoices/receipts will be sent to the email address provided in this section.

PRODUCTS AND SERVICES

1. How many systems do you install per year?

2. What types of systems are installed? (select all that apply):
Computer Networks Home Theater Home Automation Distributed Audio/Video
Phone Systems Automated Lighting HVAC Security Other:

3. What are your primary products and/or suppliers?

4. Do you perform your own installations? Yes No

Who performs your installations?

5. Purchases are: Taxable Tax exempt. Resale #:

NOTE: California-based businesses are required to submit copies of tax-exempt certificates, otherwise all orders are subject to sales tax.

MARKETING CONTACT Same as Owner
Salutation	First Name	Last Name	Title	Email	Phone

MARKETING/SOCIAL MEDIA INFORMATION
Facebook (URL)	Twitter	LinkedIn (URL)	Other

How do you plan on marketing products to prospective customers? (select all that apply):

Retail Storefront Direct Mail Newspaper/Magazine Catalog/Newsletter Internet
Designer Showroom Model Home Other:

REPRESENTATIVE FIRM

Have you already been contacted by a Pakedge Representative Firm? Yes No

Which Pakedge Representative Firm has contacted you?

If available in your region, would you like a Pakedge Representative Firm to contact you? Yes No

TERMS OF SALE

Pakedge Device & Software offers a sheltered product line of wireless networking products and accessories to be sold and installed solely by authorized dealers. A dealer and/or individuals are prohibited from reselling Pakedge Device & Software products through any other means, including but not limited to: online resellers, national distributors, regional distributors, specialty stores, or sales channels of similar method. Pakedge Device & Software does not permit public disclosure of product pricing through any medium. If it is determined that Pakedge Device & Software products are being sold through unauthorized sales channels, or if company representatives are found in violation of the sheltered product line policy, it is at the discretion of Pakedge Device & Software to restrict dealership access and/or terminate the dealer account.

I agree: By selecting "I agree," I certify that I have read and accepted the dealership terms described above.

I do not agree

CERTIFICATION
I certify that the above information is complete and accurate to the best of my knowledge.
Salutation	First Name	Last Name	Title	Email	Phone