UBA Franchise Prize Fund Claim
Form for Franchise Owners, Presidents, or an authorized team rep to inform the UBA of where to send team prize winnings ONLY via bill.com
Date
*
-
Month
-
Day
Year
Date
Your name
*
First Name
Last Name
Your email address
*
example@example.com
Name of UBA franchise
*
Who is the individual that is authorizing team payouts?
*
First Name
Last Name
What is this individual's email address?
*
example@example.com
What is their office held position on the team?
*
Owner
President
Authorized Team Rep
Is there an active bill.com account set up for an authorized team officer to receive funds for your franchise?
*
YES
NO
If you selected yes, what is the email associated with the account? If you selected no, please move to the next question
Please note: Leaving this field blank after selecting yes will cause a delay in receiving team funds
If you do not have an active bill.com account set up for your franchise, DO NOT LEAVE THIS FIELD BLANK. Below you must provide the name that will be on the account & the email address that will be associated with the account so an invite can be sent to set up the team's bill.com account & start receiving team funds. (PLEASE ACCEPT THE INVITE ON A COMPUTER/LAPTOP/IPAD when you receive the invite....DO NOT ACCEPT ON A CELL PHONE!!!)
Please note that failure to provide a valid email address will cause delays in setting up your account and a delay with receiving team funds.
Any questions or concerns, please address here. If there are none, please leave this blank.
Submit
Should be Empty: