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July 29, 2010

Computer Gate - Reseller Account Registration Form
(for Domestic Resellers in US Only)

* This form must be fully completed, and a valid state Reseller ID must be faxed in before an account can be created. Delay on the completion may cause delay in approval process.

Salutation	Mr. Ms. Mrs.
First Name		Last Name
Company Name		CEO/Owner
Company Address 1
Company Address 2	(optional)
City		State	Zip
Main Telephone	e.g. 4087300673	Extension	e.g. 1234 (optional)
Main Fax	e.g. 4087300735
Contact Person
A/P Telephone	(optional) e.g. 4087300673	A/P Fax	(optional) e.g. 4087300735
Federal Tax ID#	(optional)	Resale Certificate#
Password		Confirm Password
Email Address		Your Web Site URL	(optional) e.g.http://www.computergate.com

How do you know about us?
Annual Sales Revenue?
How many employees in your company?

* Please read carefully before submit *
Important Tax Information - Resale Certificate

To establish and maintain your account, we require that you provide us with a valid Resale Certificate in the state where you operate your business, and you will update your certificate on a periodic basis in accordance with state laws and/or Computer Gate International policy. Failure to provide an updated certificate may cause cancellation of your reseller membership with Computer Gate International. We reserve the rights to modify the Reseller Membership program at any time without notice.

	I understand and accept the terms and policy
Yes No	I would like to receive email special and catalog mailing regularly from Computer Gate

* For all US domestic resellers, in order to complete the registration, after Submit this form, you need to fill in the BOE504 form as well. Please fax the BOE504 form and your reseller certificate with signature to (408) 730-0735, Attn: Accounting Dept.

** Note for all Reseller Certificates that are Colored or have Colors in the background of the Certificate

please EMAIL us a SCANNED copy of your Reseller Certificate to cgacct@ComputerGate.com.

Customer Care

For further assistance,
please email to our Customer Service at reseller@computergate.com
M-F 7:00 a.m. - 6:00 p.m. PST