Iridium Authorization to Purchase Order Set-Up (LATP) Form

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Unique ID

Date Submitted*

Order Administration Information

Company Name*

AUTHORIZED PURCHASER ON BEHALF OF*

Company Address*

This address will appear on invoices and should match your agreement.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Primary Ship To Address*

Same as Company Address above

Other (add below)

'SHIP TO' ADDRESS (PRIMARY DESTINATION)

Company Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Do you wish to add an Alternate Shipping Address?*

*Only for use if two ship to locations are needed on the account

Yes

ALTERNATE DESTINATION

Company Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

IF THE PRIMARY OR ALTERNATE 'SHIP TO' ADDRESS IS IN THE UNITED STATES, PLEASE ATTACH COPY OF RESALE CERTIFICATE FOR EACH STATE TO WHICH GOODS WILL BE SHIPPED. CERTIFICATE MUST BE ISSUED TO “IRIDIUM SATELLITE LLC, 8440 S. RIVER PARKWAY, TEMPE, AZ 85284” BY THE IRIDIUM SERVICE PARTNER. IF THE 'SHIP TO' LOCATION IS TO A COMPANY OTHER THAN THE AUTHORIZED SERVICE PARTNER, SUCH AS A DEALER, A RESALE CERTIFICATE IN THE NAME OF THE SERVICE PARTNER IS STILL REQUIRED.

Press BROWSE below to search for and attached a document*

Max. file size: 768 MB.

ORDER PLACEMENT AND SHIPPING CONTACT

Contact Name*

First Last

Email*

Phone Number*

INVOICING AND BILLING CONTACTS

Contact Name (1)*

First Last

Email*

Phone Number*

Contact Name (2)*

First Last

Email*

Phone Number*

SMALL PACKAGE FREIGHT CARRIER*

SMALL PACKAGE FREIGHT ACCOUNT*

LARGE FREIGHT CARRIER*

LARGE FREIGHT ACCOUNT*

Name of Individual completing form*

First Last

Email of individual completing form*

Iridium Authorization to Purchase Order Set-Up (LATP) Form

Order Administration Information

'SHIP TO' ADDRESS (PRIMARY DESTINATION)

ALTERNATE DESTINATION

ORDER PLACEMENT AND SHIPPING CONTACT

INVOICING AND BILLING CONTACTS

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