RJA WIRELESS LLC

CLIENT REGISTRATION

AUTHORIZED REPRESENTATIVE

Full Name *

Title / Position *

Phone Number *

Email Address *

BUSINESS INFORMATION

Type of Business *

Estimated Monthly Purchase Volume

Products / Services *

REQUIRED DOCUMENTS

1. Company Formation Document *

2. EIN / Tax Identification Document *

3. Resale Certificate / Sales Tax Certificate

4. Government-Issued Photo ID *

CERTIFICATION & AUTHORIZATION

I certify that the information and documents provided in this Client Registration are true, accurate, and complete to the best of my knowledge. I confirm that I am authorized to provide this information on behalf of the company identified above. I understand that RJA Wireless LLC may request additional documentation or information when reasonably necessary to verify the identity or business information of the applicant. By submitting this registration, I authorize RJA Wireless LLC to review and verify the information and documentation provided for customer onboarding and compliance purposes.

Authorized Representative Name *

Date *

Signature (type full legal name) *

I confirm that the information provided above is accurate and complete.

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