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.
Do not attempt to complete this form unless you are the owner of the account in question or are a high-level executive recognized by 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 may access only the programs selected below. A maximum of 15 recipients may be added to this form. Federal law requires NRF to maintain a W-9 for all payees. Recipients receiving spiff payments must submit a W-9 before funds can be issued. Rebate payments will be made directly to the business. For questions about the FundsBuilder program, please contact NRF's FundsBuilder Program Manager.
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
Use this space for any further comments regarding this form.
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NRF Incentive Program Retailer Authorization

Authorized Recipients