Reseller Inquiry

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09/11/2001


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Authorized Reseller Program

In order to purchase software directly from Domain Entertainment for resale, resellers must meet the following requirements:
 
bulletBe an ISO/MSP/RA capable of supplying merchant accounts to customers.
bulletProvide your own customer setup and training, and front-line technical support.
bulletPurchase in quantities of at least 20 units at a time.
bulletHold a valid state reseller sales tax certificate.

If you meet the above requirements please fill out the following required form(s) and you will be contacted by voice or e-mail.

Reseller Information

    First Name: 

     Last Name: 

         Title: 

       Company: 

       Address: 

          City: 

         State: 

           Zip: 

         Voice: 

           FAX: 

        E-mail: 

           URL: 
  

Required Information

Federal ID Number
 
State Sales Tax Number

Sales Information

Program(s) Currently Sold: 
  
         Units/Month Sold: 
  
       Your Per Unit Cost: 

Total Accounts/Month Sold: 

What clearing houses do you use? (Check All that Apply)
FDR MDI ECHO Other - Specify: 

Note: If this is a new business please use estimates for Units per Month and Total Accounts per Month and check the clearing houses that are available to you.

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