Ad-ID Advertiser Permission (to be filled out by Advertiser only)

When any agency, third party or freelancer requests that a new group and account be set up, or requests access to a prefix for an advertiser that they do not currently have access to, Ad-ID requires written permission from the advertiser that the agency, third party or freelancer has permission to register ad creatives/create Ad-ID codes for them and/or to have a prefix created for the advertiser.

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Email *
Name of person filling out the Advertiser Permission form *
Advertiser Name *
Advertiser URL/Website address *
Advertiser Contact Name (if different from the person filling out the form)
Advertiser Contact Email address (if different from the person filling out the form)
If an agency and/or third party and/or freelancer will be creating the codes for you, please enter the name(s) below:

Agency and/or Third Party Name and/or freelancer

*
Currently, Ad-ID creative registrations cost $45 for all media types. Qualified Non-Profit organizations with 501(c)(3) status can have their creative registered at no charge.

Do you grant permission to the above agency/third party/freelancer to create ad registrations in Ad-ID for you?
*
Required
Do you (the advertiser) grant permission for the agency/third party/freelancer to have access to new and/or existing prefixes?

*
Required
What party is responsible for billing? *
Required
Add your initials here to indicate you’ve read this form and you confirm that the information entered is correct. *
Date *
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A copy of your responses will be emailed to the address you provided.
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