SELECT ONE:❑ NEW ACCOUNT PASSWORD REQUEST❑ CHANGE OF ADMINISTRATOR❑ CHANGE OF INFORMATIONElectronic Commerce User Agreement for www.dandh.ca
PASSWORD REQUEST FORM
Please complete the Electronic Commerce User agreement and License (“Agreement”) below and have it signed by an authorized signator and either
fax it or mail it to D&H CANADA at the address below. D&H CANADA will process your request and provide you with written notification ofyour log-in and password. We will send this via e-mail within 3 business days of the account being set up in our system. For security reasons,
D&H CANADA will only provide this sensitive information via email to the address we have on file. Read all terms and conditions of thisagreement before signing, opening any software media package (if included) or accessing the D&H CANADA Web Site or any informational
database. By opening any D&H CANADA software package or accessing the Web Site or informational database, your organization (“you”) agree
to these terms and conditions, as modified or amended from time to time and each time you access the database, software, or site, you reconfirm
your agreement. If you do not agree to these terms and conditions, you may elect not to access the database or site, and must, if applicable, return
any accompanying software product container and its contents, including any unopened software media package, to D&H CANADA. This
Agreement is effective from the day you initially use or install the software, access the database or site until such time as you cease to be an
authorized reseller of D&H CANADA.
You may access this secure site by choosing to “log-in” from various locations within the D&H CANADA non-secure site. At that point you will beprompted to enter your log-in ID and password. Your account will be initialized and ready for use when you receive your log-in and password.
Maintenance of the security of this password is your responsibility. Please guard this information as you would your credit card or bankcard number,including how it is used by the employees (current and previous) of your organization. D&H CANADA is not responsible for any unauthorized useof this information unless written notice is received and confirmed by D&H CANADA as to the termination of this program. We cannot processquestions relating to the access of our secure web site without your account number.
You, as administrator, agree to maintain your password file within dandh.ca. Please refer to the rules and regulations of the administrator in thepassword function in dandh.ca.
You agree that electronic orders placed under this Agreement are valid and are for all purposes deemed in writing, signed by you, and are admissible
to the same extent and under the same conditions as other business records between the parties. Unless otherwise agreed to in a writing signed by anofficer of D&H Canada, the terms and conditions of electronic sales made under this Agreement are contained on D&H Canada’s written invoices,and available on line, as amended from time to time.
The data provided by D&H CANADA under this Agreement has been subject to numerous control mechanisms to insure its accuracy. D&HCANADA at all times will use best efforts to maintain this accuracy as to pricing and availability of products. However, if at any time the data isincorrect as to price, availability, description, image and product attributes, D&H CANADA reserves the right to reject orders placed based on thiserroneous information. D&H CANADA shall not be liable for any damages beyond refunding the purchase price paid for the product upon its
return.
The data provided herein shall at all times remain the property of D&H CANADA and (your company name)___________________________ shalltake commercially reasonable steps to make sure this data is secured from any unauthorized use, copying transmission, downloading, or otherdistribution. Please send any questions to passwords@dandh.com.

For a new account, D&H CANADA will complete the account number line.
Customer Acct #Must complete all following information to have a password issued.
Company ______________________________________________ Email Address: _____________________________________________
Contact Name: __________________________________________
Address: _______________________________________________ City: ____________________ Province: ____ Postal Code: _________
Phone: ____________________________________
Please provide one of the following:
GST #: __________________ or Last 4 Digits of Principal Social Insurance #:______________
Do you wish to authorize drop shipping on your account? YES ❑NO ❑By signing below, I agree to the above terms and conditions:
Authorized Signature

Title

DateWe will send this via e-mail within 3 business days of the account being set up in our system. For
questions email: passwords@dandh.com
Selecting the FORGOT PASSWORD link on our homepage at www.dandh.ca can retrieve a misplaced password

Fax completed requests to: 717-255-7851 or
mail to: D&H Canada 100 Tech Drive Harrisburg, PA 17112 Attention: Web Password Admin or to send
electronically, attach and email to: passwords@dandh.com