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$4.95 Account Keeping Fee Waiver Request Form

$4.95 Account Keeping Fee Waiver Request Form

First Name
Last Name
Preferred Email
Once you have submitted the form a confirmation email will be sent to this address.
Latitude Program Manager
Store Name
Latitude Merchant ID
The Latitude merchant ID must relate to company/store name you have entered. For Apple Head Office please enter '0000'
Apple Badge No. (or Payroll ID)
The unique identification number given to you by your employer- not Latitude
I confirm that the information given in this form is true, complete and accurate.