Page 102 - Gulf Coast Division - Training Manual 5 -18
P. 102
Authorization to Release Special Pricing
Date: ____________________
Operator Name: ________________________________________
Name on Deal: ______________________________________
(only if different than Operator Name listed above)
Current Distributor Holding Deal _______________________
This is my authorization for the release of my information regarding
special pricing and/or deviations on my products to Ben E. Keith
Company.
Operator Signature: __________________________________________
Printed Name: ______________________________________________
Title: _____________________________________________________
Daytime phone number: ______________________________________
Return fax number: __________________________________________
Request submitted by: ________________________________________
Broker or Representative
