Fee Waiver Request

Please use this form for all request to waive fees to an existing customer. This form must be filled out in its entirety for final approval from Michael Kumpulanian. You should not communicate to the customer the fee has been waived until you get approval via email. For New Account waivers, send completed form and approval with the account set up form.

Date*
MM slash DD slash YYYY
Your Email*
Fee Type*
- Transportation Fee Waiver
- Minimum Order Waiver
- Drum Deposit Waiver
- Tote Deposit Waiver
- Freight Charge – K Account
Select all that apply.
TSM/Sales Account Manager
RSM/Sales Manager*
Customer Name*
Account #*
TTM Gallons
Required for Existing Accounts
TTM Margin
Required for Existing Accounts
Brand

Required for Existing Accounts
Line of Business

Required for Existing Accounts
Competitor

Required for Existing Accounts
Competitor Fee
Required for Existing Accounts
Reason for Request*