Dealer in Virginia State customer must fill out the VA State Resale Certificate and fax it back to (703) 997-8779.

Contact Information

Company Name*

GSS Sales Representative

How did you hear about us?*

Tax Identifier*

First Name*

Last Name*

Title

Prefer Contact

Phone

Telephone*

Email Address*

Address 1*

Address 2

Address 3

City*

State*

Zip*

Country

Please specify the country

Company Information

Company Type

Business Established Year

Business Established Month

Number of Employees*

Website URL*

Type of Operation

Principle geographic coverage radius in miles

Have you ever installed any electronic security products before*

Yes

If yes, please specify the Brand Name

Once download is completed, please print Dealer Agreement, initial each page, sign and email/fax to sales@gssdvr.com or (703) 997-8779.