JVC Authorized Reseller Application

§ Approval as a JVC Authorized Reseller provides you the opportunity to purchase JVC camcorders, digital cameras, VCRs, DVDs, recording media, and all related accessories.

§ In order to become a JVC Authorized Reseller, the following application must be filled out completely. Please fax your completed form to Dale Graffuis at 407-498-0076. There is a 2-3 day turnaround time once JVC receives your application.

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Tech Data Customer #

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Legal Business Name Reseller Tax ID # DBA Name

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Business Address Mailing Address

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City, State ZIP City, State ZIP

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Business Telephone Number Fax Number Company Website

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Contact Name / Title Company E-Mail

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Company Profile

§ How many locations do you have? ______

§ Are any of your subsidiaries or divisions of your company currently reselling JVC goods?

Yes __ No __. If yes, please indicate DBA name and categories being purchased.

§ What is your primary method of selling?

1. Consumer Electronics Retailer __ Brick and Mortar __ Internet __

2. Value Added Retailer __

3. Computer Retailer __

4. Catalog / Mail Order __

5. Direct Sales Force __

6. Telemarketing __

7. Internet __

8. Exporter __

9. Government Agency __

10. Business to Business __

11. Premium House __

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Authorized Reseller Terms and Conditions

§ Make no JVC products available for sale on the internet.

§ Make no JVC products available for sale via export (U.S. Domestic Market Only)

§ Make no JVC products available to authorized JVC retailers or distributors, without prior approval from JVC.

§ Make no JVC products available to manufacturers without prior approval from JVC.

§ JVC shall have the right to terminate resellers’ approval at any time, for any cause, or no cause whatsoever on seven (7) calendar days written notice with no obligation to reseller.

§ Meeting and agreeing to the above terms does not guarantee approval by JVC.

Signatures

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Officer Name Title

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Officer Signature Date