What's the best way to get rid of rats? Rat Zapper!

Become a Dealer for Rat Zapper!

Please note: this form is for existing businesses with a retail location or online store wishing to sell the Rat Zapper, NOT for individuals without an established business.

Registered resellers, click here to order online.

APPLICATION FOR RESELLER

COMPANY NAME:	Date:
STREET ADDRESS:	CITY:	STATE:	ZIP CODE:
BILLING ADDRESS:	CITY:	STATE:	ZIP CODE:

In business since:

Accts Payable contact:

PHONE:	FAX:
EMAIL ADDRESS:	WEB SITE:
BUYER NAME (if different):	BUYER PHONE (if different):

COMPANY PRINCIPALS

TYPE OF BUSINESS:
Individual Ownership	Partnership	Corp, inc. in what state?

Resale#	Tax Payer I.D.#
(Note: A completed "Resale Certificate" must be on file for tax exempt status.)

If corporation, name of officers, if partnership, name of partners:
Name & Title	Address, City, State

MARKETING PLANS

Please tell use about how you intend to sell the products and who your target market is:

BANK REFERENCES

Name of Bank:	Name of Contact:
Branch:	Address:

City:	State:	Zip:
Account#:	Ph#:	Fax#:

WHAT PAYMENT METHOD OR TERMS ARE YOU REQUESTING?

Pre-Paid
Bill Through
Net 30 - please supply credit references below

CREDIT REFERENCES

COMPANY NAME:	CONTACT:	EMAIL ADDRESS:	FAX: