Dealer Application

		KENWOOD MASTER PROTALK DISTRIBUTOR
		e Commerce Supply
		15375 Barranca Pkwy H108
		Irvine, CA 92618-2209
	K E N W O O D C O M M U N I C A T I O N S	949-502-5588 949-480-0039 FAX
	DEALER APPLICATION	www.ecom-supply.com
	DEALER APPLICATION	radios@ecom-supply.com
		radios@ecom-supply.com

(Easy On-Line Application Available at www.ecom-supply.com)

Company Name____________________________________________________________________ Date______________________________

Address/City/State/Zip___________________________________________________________________________________________________

Telephone_________________________ FAX _______________________ Web Address___________________________________________

Type of Business and Products Sold_______________________________________________________________________________________

[ ] Corporation(State_________)	[ ] SoleProprietorship	[ ] Partnership	Years in Business___________
General Manager____________________________________________________			Email Address _____________________________
Sales Manager_______________________________________________________			Email Address _____________________________
Accts Payable Contact_________________________________________________			Email Address _____________________________

TaxResale Number___________________________________ Please provide a copy of your State Tax Resale Certiﬁcate with Application

PaymentType

[ ] MajorBankcard

[ ] COD

*[ ] Net 30 Days (On Approved Credit with Opening Radio Order)

* Please allow 5 to 10 working days to process an open account application. If product is needed immediately, orders can be shipped via UPS COD or paid with a bankcard (3% fee may apply).

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BANK REFERENCE

Bank___________________________________________________ Telephone_________________________ FAX _______________________

Address/City/State/Zip __________________________________________________________________________________________________

Contact ______________________________________________________ Account Number _________________________________________

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SUPPLIER REFERENCES

Supplier________________________________________________ Telephone_________________________ FAX _______________________