PacificDigi.com
If you are a company and would like to be qualified as a reseller/distributor for Pacific Digital Electronics, please fill out this online application and fax a copy of your business license (and your state resale license if you are reselling) to (818)302-1644. You can skip the EIN and State Resale Number if you are located outside of the United States. One of our account managers will contact you as soon as we received all the required information and documentation.
*This application must be completed in full. Incomplete applications will be rejected. Completion of this application does not imply that you have been accepted.
Company Information:
| *Company Name: | |
| Federal Tax ID (EIN): | |
| State Resale Number: | |
| *Contact Name: | |
| Contact Title: | |
| *Company Address: | |
| *City: | |
| *State: | |
| *Zip Code: | |
| Country | |
| *Tel #: | |
| Fax #: | |
| *E-mail: | |
| Website URL: |
Company Background:
| *Type of Ownership:: | |
| *Year Established: | |
| *Number of Employees: | |
| *Annual Revenue: | |
| *Purchasing Agent: | |
| *AP Contact: | |
| *Owner/President: | |
| Partner/VP: |
Nature of your business:
| Traditional Reseller | Wholesaler | System Integrator | |||
| Internet Reseller | Distributor | Manufacturer | |||
| Value Added Reseller | Importer | OEM / ODM | |||
| Other: | |||||