Value Added Reseller

Quinto Game Company LLC
P.O. Box 310
Ashton, MD 20861
Telephone (301) 439-1067
Fax (301) 434-8642
Toll Free (866) 784-6865
comments@quintogame.com

Reseller Information


If you are interested in selling Quinto products, you may do one of the following:

	•	complete our online reseller form shown below; or
	•	download the reseller form in Adobe Acrobat (.pdf) format, print and mail the completed form to the address shown above; or fax the completed form to the fax number shown above; or
	•	call our toll free number shown above and a sales representative will attend to your needs as soon as possible.

On-line Reseller Form


	Company Name*

	Billing Address*

	City*

	State*		Zip*

	Billing Contact*

	Shipping Address*

	City*

	State*		Zip*

	Buyer Name*

	Phone*

	Email*

	If you have any questions about our products, please include them in the field below.


	Providing us with the additional information below will help us to expedite the approval process.

	Company

	Federal Tax ID Number

	Owner Name

	Phone Number

	Legal entity (check one)	Corporation Partnership Proprietorship

	Length of time in business

	How long at present location

	Bank Reference

	Bank Name

	Account Rep

	Phone Number

	Account Number

	Bank Address

	City

	State*		Zip*






*required information.