Software Central Submission
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GENERAL CONTACT INFORMATION - FOR ADMINISTRATIVE USE ONLY

* Required

Marketing/Business Development Contact Information
First Name: *
Last Name: *
Title:
Company:
Email: *
Phone: *
Company URL: *

Accounts Payable Information
Remittance for U.S. and Canadian-based companies will be by check. For other companies, remittance will be by wire transfer when the revenue amount exceeds $1000 U.S. To send you your quarterly revenue check or wire transfer, please complete the information below:

Contact Name:
Department:
Company:
Address:
City:
State:

Zip/Postal Code:
Country:

Bank Wiring Information
Company name on bank account:
Company address:
Routing & Transit number:
Account number:
Bank Name:
Bank Address:
Bank City:
Bank State:

Special Instructions:
Bank Zip/Postal Code:
Bank Country:

Note: Payment will be held until revenue accrues to $1000 US unless you use your own E-Commerce system and add U3 as a parter with 50% - 50% revenue.
Technical Support Method
Technical support URL for software program: *

Technical support email for software program: *

Your U3 Business Development Contact (optional):
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