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PayGO Distributors, LLC Distributor Agreement This PayGO Distributors, LLC Lifeline Distributor Agreement (the “Agreement”) is made as of _____, 2015 the “Effective Date”, between _________________(“Distributor”) and DK Distributors, LLC, dba PayGO Distributors, LLC a Texas limited liability company (“PayGO”).
State_________ Zip __________ Driver’s License # ____________________________ State___________ I authorize PAYGO Distributors to conduct a background check on me.
- I agree that all Lifeline Customer Confidential Information collected by me, if any, will be forwarded in its entirety to PayGo Distributors.
PayGo Telephone Number: 844-55-PAYGO Address:
PayGo Distributors 6081 02/21/2015 Field Rep 14 Day Shadow Rep Rep Reinstatement Site Manager Applicant Vandi Alexander Field Rep or Shadow Rep Site Manager OBP Submitted by APPLICANT INFORMATION Full Name:
or •TO BE COMPLETED BY MASTER REP• Master Rep Name Portal ID (first 4 digits) Paygo Distributors 6081 Application Date: