NRF Incentive Program Retailer Authorization

NRF Incentive Program Retailer Authorization

Please complete this form to authorize your business as a participating retailer in the NRF Incentive Programs
Store Owners may designate an Authorized Store Representative to act on their behalf for all matters related to our Fund and Spiff Programs. An Authorized Store Representative is permitted to participate in program activities, engage in discussions, access relevant program information, and receive any associated payouts. The Store Owner remains fully responsible for all actions taken by the Authorized Store Representative under this agreement. A valid W-9 Form must be on file with NRF before any payout can be issued to an entity other than the business listed on file with NRF.
NRF Account Name
Name of the business
NRF Account Number
Format should be in '000000'
Account Owners Name

First NameLast Name
Account Owners Email Address
example@example.com
I, the undersigned, authorize the below people to register, renew, and redeem payout documents for my account relating to the following Incentive Programs.
Authorized Signature
Date

MonthDayYear
Authorized Recipients

Recipients can only access the programs that are selected below. Add up to 15 recipients on this form. Federal law requires that NRF keep on file W-9's for all payees, so the recipients will need to file a W-9 with NRF before payments could be made.
Spiff Programs (NRFSelectRewards.com)
Renewal of Rebate Programs
FundBuilder Programs
Authorized Recipient 1

First NameLast Name
Authorized Recipient 2

First NameLast Name
Authorized Recipient 3

First NameLast Name
Authorized Recipient 4

First NameLast Name
Authorized Recipient 5

First NameLast Name
Authorized Recipient 6

First NameLast Name
Authorized Recipient 7

First NameLast Name
Authorized Recipient 8

First NameLast Name
Authorized Recipient 9

First NameLast Name
Authorized Recipient 10

First NameLast Name
Authorized Recipient 11

First NameLast Name
Authorized Recipient 12

First NameLast Name
Authorized Recipient 13

First NameLast Name
Authorized Recipient 14

First NameLast Name
Authorized Recipient 15

First NameLast Name
Should be Empty:

NRF Incentive Program Retailer Authorization

Authorized Recipients