Lexmark Partner Application Form

We're glad you are interested in becoming a Partner!

Please fill out the application form so we can learn more about you.

* = Required

Your contact information

Please fill in the following information about where you are located and how you may be contacted.

Country

Title

First name

Surname

Job Title

Phone number Phone number format: Do not include spaces or dashes.

Email Review the accuracy of the email address to ensure successful communication from Lexmark.

Distributor Relationship

Please fill in the following information about your distributor contacts.

Distributor who referred you to Lexmark

Name of referring distributor if not listed above (optional)

Distributors with whom you have a relationship/account to source product

Authorization through other distributors, if not listed above (optional) Separate each additional name with a comma.

Reseller information

Please fill in the following information about your business.

Reseller business name(s)

Legal business name

Primary DBA (Doing Business As) name

Other DBA names (optional) Separate each additional name with a comma.

Reseller business address

Address line 1

Address line 2 (optional)

Town/City

County

Postcode

Reseller contact information

Phone number Phone number format: Do not include spaces or dashes.

URL URL format: http://www.yourcompany.com

Reseller business certifications

Tax number/VAT number Tax number/VAT format: Do not include spaces or dashes.

Dun & Bradstreet (D-U-N-S) number if available D-U-N-S number format: Do not include spaces or dashes.

* State reseller certificate

Browse files File must be a PDF, DOC, DOCX, JPG, JPEG, PNG and not larger than 4MB.

Additional tax documentation (optional)

Browse files File must be a PDF, DOC, DOCX, JPG, JPEG, PNG and not larger than 4MB.

Reseller operational details

Primary focus of business

Sell to consumers

Sell to other businesses

Target markets you serve

Additional target markets, if not listed above (optional) Separate each additional name with a comma.

Primary path to market/business model

Additional paths to market, if not listed above (optional) Separate each additional name with a comma.

Have you previously sold Lexmark products?

Yes

Do you sell Lexmark competitor products?

Yes

Lexmark competitors would include Brother, Epson, HP, Xerox, Ricoh, Kyocera, etc.

Reseller financial details

What is the total annual revenue of your business?

Less than $49,999

$50,000 - $99,999

$100,000 - $499,999

$500,000 or more

What percentage of your total business makes up Printers / Multi-Function Printers?

1% - 24%

25% - 49%

50% - 74%

75% - 100%

Out of your Print business, how much is in printer hardware?

1% - 24%

25% - 49%

50% - 74%

75% - 100%

Not applicable - we do not sell hardware.

Out of your Print business, how much is in supplies / toner?

1% - 24%

25% - 49%

50% - 74%

75% - 100%

Not applicable - we do not sell supplies.

Out of your Print business, how much is in Managed Print Services (MPS)?

1% - 24%

25% - 49%

50% - 74%

75% - 100%

Not applicable - we do not sell MPS.

How much of your Print business is made up of Lexmark products and services?

1% - 24%

25% - 49%

50% - 74%

75% - 100%

Not applicable - we do not sell Lexmark products yet.