KimLyTech LLC New Buyer Application

1

Company Name* This field is required.

2

Contact Name* This field is required.

First Name

Last Name

3

Email* This field is required.

example@example.com

4

Phone Number* This field is required.

Country Code

Phone Number

5

Shipping Address* This field is required.

Street Address

City

State

Zip Code

Country

6

What is Your Business Model?* This field is required.

Retail

Wholesale

9

What Device Conditions Do You Purchase?* This field is required.New = Sealed/Unopened, Used - A Grade = Fully Functional (Like New), Used - B Grade = Fully Functional (Moderate Wear), Used - C Grade = Fully Functional (Heavy Wear)

New

Used - A Grade

Used - B Grade

Used - C Grade

10

What is Your Monthly Purchasing Volume for Mobile Devices?* This field is required.Please select from the drop down menu below the number of mobile devices you purchase each month.

11

Is Your Company R2 Certified?* This field is required.

YESNO

12

How Did You Hear About Us?

13

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