New Reseller Application Form - Domestic Form
Company Address Information - Must match your Business License
Ex. 92590
    
Contact Information
Ex. 951-252-8700
Business Information

You may supply a credit card number now that we will securely keep on file, eliminating the need to type it in and send it over the internet with each order.
Credit Card
State

Please upload a copy of your State Issued Business License (where applicable)

If in California, I will also submit a completed copy of our Blanket Certificate of Resale. Please refer to this link to register with the state if you have not already done so http://www.cdtfa.ca.gov/services/#Register-Renewals
Any invalid PDF,JPG or PNG file will be rejected, if your file is not a PDF,JPG or PNG please use a tool to convert your file before uploading. Click here for results on Google (Evertek is not responsible for any of these sites, this is just to help you find a tool to convert to PDF)
NOTE: Your account cannot be activated until we receive ALL required documents.
We look forward to doing business with you!
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!