Notice: This form is for use by official iTransact Resellers. If you are not a Reseller and are setting up an account for your own use, please select the purchase or lease option here. All fields are required. Click the PROCESS AND CONTINUE button at the bottom of the form when completed. For questions, please call iTransact at (801) 298-1212.

1. RESELLER INFORMATION

Reseller CODE:

2. YOUR CLIENT'S GENERAL INFORMATION

Business Name: (If no business name, enter contact name.)
First Name:	Last Name:
Title:
Address:
City:	State: Zip:
Country:
Web Site URL:
Contact Phone Number:
Customer Service Phone:
Fax Number:

3. YOUR CLIENT'S EMAIL INFORMATION Click here for an explanation of each email address.

General Contact Email:
Email for Orders:
Email for Order Form Errors:

4. PASSWORD Please select a password for your client to use. It must be six to ten characters in length. Since this may be changed at any time by your client, you may enter a generic password. Please be sure to let your client know what password you have chosen.

Password:
Verify Password:

DO NOT PRESS STOP ONCE YOU HAVE SUBMITTED THIS FORM. INFORMATION IS PROCESSED IMMEDIATELY.