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Become a Reseller
If you wish to become a reseller please fill out the form below:
Company Information
Section 1 - Business Information
Legal Business Name:
*
*As it appears in business license
Business Telephone Number:
*
FAX:
E-mail:
*
FED TAX ID#:
*
Federal Tax ID Number
City:
*
State:
Zip Code:
Country:
*
Website:
*
SIP:
Toll Free Number:
Type of Business
Type of Business:
*
- Select -
Corporation
Partnership
Proprietorship
LLC
LLP
Other
Year Established:
State of Incorporation:
D&B Number:
Number of Employees:
*
- Select -
1-5
6-14
15-25
26-50
51-100
More than 100
Are you a Subsidiary or Division?:
- None -
Subsidiary
Division
Please select the chanel programs that you would like to join
Select:
SANGOMA
3CX
SNOM
AASTRA
MEDIATRIX
GRANDSTREAM
CISCO
PATTON
NET
2N
TRIXBOX
AUDIO CODES
ELASTIX
DIALOGIC
INCONCERT
VXI
PLANTRONICS
JABRA
3COM
SIP Trunking:
Please indicate if you have any existing agreement
Section 2 - Authorizations
Please list any authorized reseller agreement that you may have:
*
Which brands do you sell?( List the ones that make 60% or more of your annual revenue):
*
Please specify which vertical markets you address::
*
Authorized Signature
I hereby certify that all the information given herein is true and correct to the best of my knowledge; and I understand that providing incorrect information on this application may result and possible delay or denial. I have read this application. This application is not an agreement and does not guarantee me acceptance to receive a XmarteK Reseller Agreement and in no way binds me to any obligation with XmarteK.
Name:
*
Title:
*
E-mail:
*
Date:
*
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