VAR Identity Information

Company Name *

Company DBA

Company Website *

What is your company’s annual gross revenue? *

Year Business Established *

First Name *

Last Name *

Title *

Address Line 1 *

Address Line 2

City *

State *

Principal Phone *

Principle Email *

Primary Distributor of Choice * Tech DataSynnexCranelIngram MicroNew Wave

Account # (If Available)

Secondary Element of Choice * Tech DataSynnexCranelIngram MicroNew Wave

Account # (If Available)

How many Sales Reps does your company have? *

How many are dedicated to document capture/management software or hardware sales?

How many sales engineers and support technicians does your company have? *

Do you focus on a particular vertical market for scanner sales? If so, which?

What other brand scanners do you sell?

What document management/capture software do you sell?

I Agree *

1 + 0 = ? Please prove that you are human by solving the equation *