To Whom It May Concern:
I have recently become a member of AuDConnex, LLC and hereby authorize Phonak / Lyric to establish or connect an AuDConnex associated account and/or affiliation. I further authorize the de-activation and/or removal of any other buying groups or accounts as deemed necessary in order to establish a business relationship with AuDConnex, LLC.
I hereby authorize AuDConnex, LLC. to be granted account information in regards to product orders, returns and exchanges for the purpose of managing and distributing any discounts or rebates that may be earned in a given purchasing cycle.
Please complete the following for each Bill To office location