Reseller Application

Step 1 of 2

1. Applicant Business Details

Business Structure
Registered Business Address
Delivery Address (if different)

2. Primary Contact Details

3. Reseller Portal Access

PTX Industrial may provide approved resellers with access to a secure reseller portal for: placing orders / viewing reseller pricing / accessing product documentation / obtaining technical information. Please indicate whether you require portal access.
Portal Access

4. Business Profile

Examples: Industrial equipment supplier / engineering services / testing services / calibration services / online retailer / distributor
Do you currently sell similar products?

5. Terms & Conditions of Sale (Cash Terms Only)

These Terms and Conditions apply to all sales of goods supplied by PTX Australia Pty Ltd (ABN 59 687 961 057), trading as PTX Industrial

6. Declaration

I certify that I am authorised to sign this document as an authorised officer on behalf of our company, that the information provided in this application is true and correct and that the primary purpose of this application is for sourcing PTX Industrial’s products for re-sale and not for internal use or consumption by our company or a related party. I agree to promptly inform PTX Industrial if there are any material changes to any of the information stated in this application. I certify that I have read and understood these Terms and Conditions of Sale of PTX Industrial which form part of and are intended to be read in conjunction with this application and agree that these Terms and Conditions of Sale shall apply to all transactions between us.

Full Name
Clear Signature
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