Fillable Farm Bureau / Verizon Discount Program printable pdf download

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ARM

UREAU

ERIZON DISCOUNT PROGRAM

By becoming a member of Farm Bureau, you’ve taken the first step to become eligible for the discounts

available through Verizon Wireless for your company, including your full- and part-time employees. However,

some restrictions apply.

To participate in the Oregon Farm Bureau-Verizon Wireless agreement:

1. Your company must derive all or substantially all of its revenue from the agriculture industry or the

business of commercial agriculture.

2. You must be a current, paid-up Voting or Supporting member of Farm Bureau, appearing on Farm

Bureau’s membership list.

Yes: _____ I comply with the two conditions above.

Yes: _____ My Verizon wireless account is set up as a Business Account under my business or farm name

with my federal tax ID. (If your account is under your name, you will need to call Verizon at 800.922.0204 and

change your personal wireless account into a “Business Account” under the name of your farm or ag business

in order to be eligible for this discount.)

If you can answer YES to both criteria above, proceed to the next part of this form.

To become enrolled in the Verizon Wireless discount program for Farm Bureau member companies, please

provide the following information:

Business Name__________________________________________________________________________

Street address ___________________________________________________________________________

City_________________________________________ State________Zip___________________________

Contact name_____________________________________ Title __________________________________

Email ______________________________________________ Phone ____________________________

Dunn & Bradstreet Number (if you have one)____________________ FedTaxID_______________________

(If your farm or ranch business does not have federal tax ID, use your social security number.)

Current Farm Bureau membership number _____________________________ Exp date:_________

Verizon Business Account number or mobile number ______________________________________

Approximately how many wireless lines of service do you anticipate needing for your company and your

employees? ______________________

Return this completed form to OFB’s Melissa Armour at , fax: 503.399.8082, postal

mail: OFB, Attn: Melissa Armour 1320 Capitol St. NE, Suite 200, Salem, OR 97301

Once we have this information, Verizon Wireless will assign a local sales representative to help you complete the

enrollment process and make any additional purchases. The enrollment process may take up to 15 days, and the

discount may not appear for two billing cycles. However, OFB and Verizon will move your application along as

quickly as possible. Have questions? Contact Melissa Armour at 503.399.1701, .

Farm Bureau / Verizon Discount Program