New Reseller Application Form - Canadian Form
Address Information
ex. K1A 0B1
    
Contact Information
Please enter the phone number starting with your country code, city code and number.
Please enter the phone number starting with your country code, city code and number.
Business Information
Please upload a copy of your International Business License
NOTE: Your account cannot be activated until we receive ALL required documents.

Notice of Compliance with U.S. Export Control Laws and Regulations

It is the strict policy of Evertek to comply with all U.S. export control laws and regulations in connection with the sale and export/shipment of Evertek products to our customers. U.S. export control laws and regulations embargo and otherwise prohibit or restrict trade with the following countries: (a) Cuba, (b) Iran, (c) North Korea, (d) Sudan, and (e) Syria, as well as proscribed or controlled destinations, end-users or persons/entities, identified on any of the following lists/databases:

1. U.S. Dept. of Commerce Entity List: https://www.bis.doc.gov/entities/default.htm

2. U.S. Dept of State OFAC List: https://www.treas.gov/offices/enforcement/ofac/sdn/

3. OFAC Sanctions List: https://www.treas.gov/offices/enforcement/ofac/programs

4. U.S. Dept. of Commerce Denied Persons List: https://www.bis.doc.gov/dpl/default.shtm

No Evertek products may be sold, exported, re-exported, shipped, trans-shipped, drop-shipped, distributed, transferred or released, either directly or indirectly, to any of these countries, destinations, end-users, persons or entities, including but not limited to, nationals of these countries, or to companies organized or located in these countries in violation of U.S. export control laws and without first obtaining an express determination from Evertek (and to the extent necessary the U.S. Dept. of Commerce and U.S. Dept. of State) that any such transactions(s) are permitted by U.S. law.

Please read and retain the required Destination Control Statement set forth below certifying your agreement that all transactions with Evertek comply with U.S. Export Control laws and regulations. If you have any questions, please contact your Evertek Account Manager.


Destination Control Statement

All products sold by Evertek to Customer (whether goods, commodities, technology or software) shall be exported from the United States in accordance with U.S. Dept. of State (OFAC) Export Administration Regulations. Diversion contrary to U.S. law is prohibited.

Customer therefore certifies that it has and shall at all times comply with all U.S. export laws and regulations, including but not limited to, the aforesaid Dept. of Commerce and State Dept. Lists, and that it shall not at any time, directly or indirectly, divert any such products in violation thereof.

Customer further certifies that it has provided Company with true and complete information regarding its ownership, the purchase (and purchaser) of said products, and represents and warrants that the purchase/sale is not prohibited by any U.S. export control laws or regulations applicable to the transaction (including trans-shipment, end-use or distribution to any end-user).


I agree to comply with the U.S. Export Control Laws and Regulations as set forth in the Notice of Compliance
Login Information
Must be between 6 to 20 characters. May include Letters or Numbers. No Spaces. May include these special characters:\ ! @ # $ % ^ * ( ) _ + { } [ ] : ; - ? / . , &
Add Me to the Evertek email broadcast!
I have read and understand all Terms and Conditions.


We look forward to doing business with you!