Get Ultra Mobile Authorized Retailer Acknowledgement Form 2014-2025

Completing the Ultra Mobile Authorized Retailer Acknowledgment Form online is a straightforward process. This guide provides clear and detailed instructions to help you fill out each section of the form accurately.

Follow the steps to complete the form online effectively.

1. Click ‘Get Form’ button to obtain the form and open it in the provided editor.
2. Enter the date of authorization in the appropriate field at the top of the form. This date marks when the form is submitted.
3. Fill in your business name in the 'Retailer Agreed and Accepted' section, followed by your authorized retailer location in the designated field.
4. Provide your principal signature, first name, last name, title, and date. Ensure all information matches your official business documentation.
5. Complete the sections for the exclusive master agent, including their business name, principal's signature, title, email, phone number, and the date.
6. List all previously used UltraAgents.com retailer codes in the provided section.
7. If applicable, input your epay terminal ID or Emida site ID.
8. Select your exclusive master agent from the dropdown menu. Indicate whether the location is a permanent retail address by selecting 'Yes' or 'No' and providing additional details if necessary.
9. Indicate whether you want this retail location displayed on the Ultra Mobile store locator, along with your reasons if you select 'No.'
10. Ensure to attach a copy of the W9 submitted to the master agent, if required.
11. Review all entries for accuracy. Save changes, download the form, print it, or share it as needed.

Complete your Ultra Mobile Authorized Retailer Acknowledgement Form online now to start your enrollment!