Information about http://www.palmbeachclassifieds.com/adinfo/rates/other/fax_consent.pdf

CONSENT TO RECEIVE FACSIMILE MESSAGES The…

Tags: facsimile equipment, facsimile messages, fax number, florida pennysaver, grants, la palma, lessee, newspapers inc, palm beach, palm beach post, signature, transmissions, undersigned,
Pages: 1
Language: english
Created: Thu May 26 13:10:58 2005
Display cached document
Page 1
image
                       CONSENT TO RECEIVE FACSIMILE MESSAGES


The undersigned, being the owner/authorized representative for the below-named company (the
"Company"), hereby grants on behalf of the Company its express permission and consent to
receive advertising offers and information via fax transmissions from Palm Beach Newspapers, Inc.
d/b/a The Palm Beach Post, La Palma, Florida Pennysaver and The Palm Beach Daily News).

I further represent that the Company is the owner or lessee of the facsimile equipment that will be
used to receive fax messages at the number(s) noted below, or the authorized representative of the
equipment owner or lessee.

Fax number(s) covered by this consent:

(_____) _________ - ____________

(_____) _________ - ____________

(_____) _________ - ____________

(_____) _________ - ____________

(_____) _________ - ____________


Company Name: _____________________________________________


Signature: ________________________________________________


Print Name: ______________________________________________


Title: ____________________________________________________


Date: ____________________________________________________