Sample Authorization Form

1 Step 1

Requested by:

Sales Rep first name

Sales Rep last name

Date needed by

Sales Rep email

Distributer

Agency Information

Agency name

Agency Size - # of Officers

First nameAgency POC

Last nameAgency POC

EmailAgency POC

PhoneAgency POC

Agency Addressaddress 1, address 2, city, state, zip

Product Information

Product InformationBallistics, carriers, plates, helmets, etc. all need to be entered as separate line items!

Item	Size	Color	Gender	Qty	Comment	Bravo or Legacy
							×

(1)

Notes and Comments

0 /

Ship to

First name

Last name

Ship to addressaddress 1, address 2, city, state, zip

F067 Rev 4 (4/12/2018)