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Optimum Reseller Application

Company Information                                                  
Company Name *:
DBA:
Street Address *:
City *:
State or Province *:
ZIP or Postal Code *:
Country *:
Main Phone *:
Toll-Free:
Fax:
Web Site

Sales Contact
Title
Email

Marketing Contact
Title
Email

Technical Contact
Title
Email
Business & Marketing Information                              
Year Established: Gross Annual Sales: $
Number of Locations: Number of Employees:

Which of the following best describes your business ?



Have you sold Multi-Tech products before ?

Which of the following best describes your major product focus ?


Distributor Relationships                                             

Please name the distributor(s) from which you'd like to purchase Multi-Tech products, along with your customer number:
Distributor Account Number
Reseller's Tax Exemption Verification                        

I, the purchaser, hereby claim exemption from the payment of state sales or use tax on the purchase of tangible personal property consisting of data communication hardware and accessories from Multi-Tech for the purpose of resale or demonstration of resale product. I understand that it is a criminal offense to give an exemption certificate to the seller for taxable items that I know, at the time of purchase, will be used in a manner other than that expressed in this certificate.

Federal ID # / Social Security # / GST#
Certificate of Registration Number (if any)

Date of Registration
Expiration Date (if any)
Type of Business *
Telephony Authorized Optimum Reseller Agreement
U.S. and Canadian Resellers Only

Only Telephony Authorized Optimum Resellers may sell MultiVOIP® and FaxFinder® solutions. This agreement verifies that you have attended a Multi-Tech Unified Communications solutions webinar sales and technical training course, or have been trained via your own self-training program. With this training, and by completing this agreement, you certify that you have the knowledge and ability to sell, as well as, provide on-site installation and support of Multi- Tech Unified Communications solutions. In addition, you agree not to advertise Multi-Tech Unified Communications products on the Internet for anything less than MAP* (Minimum Advertised Price) or MSRP. Failure to adhere to this agreement will immediately exclude you from selling Multi-Tech certain Unified Communications products.

* Call your Multi-Tech sales representative for MAP pricing.

Qualified Training Completed:

Signature                                                                      
The statements provided in this application and in the attached documents are true and complete to the best of my knowledge. I also understand that information submitted in this application will be treated discreetly by Multi-Tech and that my providing inaccurate and/or false information may be grounds for Multi-Tech to terminate any future business arrangements.

Signature Name
Title