PayGoLifelineSalesRepConfidentialityTrainingAck (PDF)

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Title: Microsoft Word - PayGo Lifeline Sales Rep Confidentiality and Training Acknowledgement 07.17.14.doc

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I acknowledge and agree that by assisting applicants with signing up for lifeline plans, I will
become privy to confidential applicant information (“Lifeline Customer Confidential
Information”). Such information includes but is not limited to the following:
- Names; Addresses; Last 4 of Social Security Numbers; Verification documents,
including proof of government program participation or income; and, any other
information that can be reasonably identified as confidential information of potential
lifeline subscribers.
In connection Lifeline Customer Confidential Information, I agree as follows:
- Lifeline Customer Confidential Information is highly confidential, and I will not
disclose Lifeline Customer Confidential Information to any other person or entity
- I will not retain any originals or copies of the Lifeline Customer Confidential
Information (including any applications).
- I agree that all Lifeline Customer Confidential Information collected by me, if any, will
be forwarded in its entirety to PayGo Distributors.
- I may only retain the name and tracking orders for commission tracking purposes.
- I will be liable for any breach of the confidentiality requirements set forth in this
In addition, I hereby certify that I have read and reviewed the following documents:
- Lifeline Program Training _______ (Initial)
- Lifeline Test _______ (Initial) 
Furthermore, as an independent contractor, I understand and agree that I am not an employee of
PayGo Distributor

Print Name: ____________________________
Signature: _____________________________
Address: ______________________________
Date: _________________________________

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