Agency Relations - SMFBA Acknowledgment of Reporting Changes

Sign to acknowledge changes with policy and procedures and reporting changes. Thank you

Signing below acknowledges that I have received the information updates regarding changes in reporting and the roll-out of the new policy & procedure manual scheduled for release at the end of December.

Question Title

* 1. Address

Agency Name

Account Number

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

County

Email Address

Phone Number

Question Title

* 2. Select the box below to acknowledge.

I acknowledge that I have been informed of the requirement to submit monthly reports to maintain partnership with SMFBA. I further acknowledge that my December report will be due January 1 but no later than January 5th.

Thank you for your RSVP. A reminder email will follow.