Reseller Application After completing this form, email or fax your State Reseller Certificate to: [email protected] or fax: 404-351-0911 Company Name: Contact Name: Mailing Address: City, State, Zip: Phone: Fax: Federal Tax ID (EIN or SSN): Email: How did you discover Advantage Laser Products? Do you require Purchase Order Numbers to be on invoices for payment? NoYes Do you want your product privately labeled with your name and phone? YesNo Will you request orders to be drop shipped directly to your customers (No additional charge)? YesNo Would you like to reply for Net 30 terms? NoYes What is your website address? Notes, Questions, Requests: I understand that products purchased from Advantage Laser Products, Inc. are for resale and not for my personal or company use. I further understand that if toner cartridge purchases do not average at least two per month, I may jeopardize my RESELLER status and forfeit wholesale pricing. Please enter the following code into the box provided: By clicking submit, you agree to the above statement.