Reseller Registration Information

PLEASE READ: Registering to become an Authorized Reseller is a two (2) part process.

• Fill out registration form below with all required information

• Once submitted, please allow 24-36 hours to process your registration form

• After we have had the opportunity to confirm your company information, please look out for the reseller agreement which will be sent to the PRIMARY EMAIL listed when registering via Docusign

• Once you have signed and returned agreement, you will receive an email notification that agreement has been executed.

At that time, you will become an Approved Authorized Reseller of Battery Tender® products!

Company Name*

DBA Name (if applicable)

DBA Name if applicable: All DBA's or ficticous names that will be used in conjunction with selling Deltran product

Customer Type*

Billing Address*

Shipping Address*

You may add additional shipping addresses in My Account or during the checkout process once your account has been approved.

Same as billing?

Physical Address* (if different from billing address)

Different?

Phone #*

Does your Company plan on selling Deltran products online?

Tax ID (EIN) #*

Primary Contact*
(No Special Characters within Email)

Buyer Contact
(Only include if Buyer Contact is different from Primary Contact)

Marketing Contact
(Only include if Marketing Contact is different from Primary Contact)

Sales Manager Contact
(Only include if Sales Manager Contact is different from Primary Contact)

Accounts Payable Contact
(Only include if Accounts Payable Contact is different from Primary Contact)

General Accounting Contact
(Only include if General Accounting Contact is different from Primary Contact)

Customer Service Contact
(Only include if Customer Service Contact is different from Primary Contact)

Shipping Contact
(Only include if Shipping Contact is different from Primary Contact)

Is your company associated with any buying groups or distributors? If yes, please list the one(s) you are currently purchasing Deltran products from.

Buying Groups*
Who do you currently purchase your Deltran Products from (Battery Buying Groups or Distributors)?

Tax Resale Certification Number

Preferred small package carrier

3rd party billing account number

3rd party account zip code

LTL carrier choice

Collect or 3rd party

Account number if 3rd party

*If no shipping account information is provided Deltran will select the carrier and shipping charges will be added to the invoice.

Reseller Registration Information

COMPANY

CUSTOMER SUPPORT

BRANDS

MY ACCOUNT