Promo Exception Request

"*" indicates required fields

Please complete this form if you are making an exception request for a customer. Be as detailed as possible to ensure this is a justified request and a prompt decision can be made to approve the request.

Rep Information (Name & Territory Number)*

Rep Name (First & Last) Territory Number

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First Name

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Last Name

Rep Email*

Regional Director Name*

Please select your Regional Director from the list below:

Account #*

Enter the account number and name of the firm you are requesting a promotion exception for.

Acct # Account Name

Customer Buying Program*

Please select which buying program this customer is currently on:

Does this account have any price caps, upfront payments, prebates or special allowance (not fixturing or consignment)?*

Order Priority*

Upfront Payments/Cash/Allowances*

Please specify any upfront payments, pre-bates or special allowances currently on this account.

Are you a US rep?*

Exception Requested (US)*

Please select which type of exception is being requested

Exception Requested (Canada)*

Please select which type of exception is being requested

File Upload

If multiple branches, please upload your file(s) here

Drop files here or

Max. file size: 256 MB.

Rolling 12 Burial Volume*

*Note: Cannot enter 0 as value. If do not have R12 data, please enter N/A or --.

Estimated Unit Growth through Factory Direct

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Estimated Unit Growth through AMP 2.0

Should this customer receive Direct Marketing materials about Factory Direct?*

Yes

Tier 2 Collection*

Solstice Cedar

Check the collection for which you are requesting to be added to Tier 2 NewPointe Price

Tier 3 Collections*

Check all collections for which you are requesting to be added to Tier 3 NewPointe Price

Tier 3 Collections - Canada*

Check all collections for which you are requesting to be added to Tier 3 NewPointe Price

Solstice Cedar*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Virgo*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Argo*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Hercules-28 Gasketed*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Hercules-28 NGS*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Hercules - 32*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Aries*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Pisces*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Spectra*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Gemini*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Apollo*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Libra*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Lyra*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Lynx*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Aquarius*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Vega*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Lunar Collection*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Tier 4 Collection Groupings*

Check all groupings for which you are requesting to be added to the Tier 4 Newpointe Price.

Tier 4 Collection Groupings - Canada*

Check all groupings for which you are requesting to be added to the Tier 4 Newpointe Price.

Aquarius*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Vega*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Virgo*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Apollo*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Gemini*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Spectra*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Argo*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Aries*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Pisces*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Libra*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Lynx*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Lyra*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Lunar Red*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Lunar Brown*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Hercules - 28 Gasketed*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Hercules - 28 NGS*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Hercules - 32*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T4 approved

Tier 5 Collection Groupings*

Check all groupings for which you are requesting to be added to the Tier 5 Newpointe Price.

Apollo*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Gemini*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Spectra*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Aries*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Argo*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Virgo*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Aquarius*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Vega*

*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Hercules - 28 - Gasketed*

*Note: Cannot enter 0 as value. If do not have R12 data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Hercules - 28 NGS*

*Note: Cannot enter 0 as value. If do not have R12 data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Hercules - 32*

*Note: Cannot enter 0 as value. If do not have R12 data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Lyra*

*Note: Cannot enter 0 as value. If do not have R12 data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Lynx*

*Note: Cannot enter 0 as value. If do not have R12 data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Libra*

*Note: Cannot enter 0 as value. If do not have R12 data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Lunar Red*

*Note: Cannot enter 0 as value. If do not have R12 data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Lunar Brown*

*Note: Cannot enter 0 as value. If do not have R12 data, please enter N/A or --.

Enter Rolling 12 volume Enter estimated total volume if T3 approved

Tier Rental Caskets & Inserts

Enter Rolling 12 volume

Enter estimated total volume if approved

REMINDER: AMP customers already get special pricing on rental caskets, rental inserts, and alternative containers. Likewise, all AMP customers are eligible for the tiered net pricing on urns. Any submissions for AMP customers will not be processed. *Rental Caskets & Inserts include: Beckham, Brockton, Linford, Crepe Inserts, Velvet Inserts *Alternative Containers include: Stratus, Standard, Standard Brown, Trayview

Tiered Cremation Containers, Caskets and Inserts

Check all collections for which you are requesting to be added to Tiered Container price.

TIER 2 RENTAL CASKETS & INSERTS

TIER 3 RENTAL CASKETS & INSERTS

ALTERNATIVE CONTAINERS

TIER 2 Rental Caskets & Inserts

Enter Rolling 12 volume

Enter estimated total volume if approved

TIER 3 Rental Caskets & Inserts

Enter Rolling 12 volume

Enter estimated total volume if approved

Alternative Containers

Enter Rolling 12 volume

Enter estimated total volume if approved

REMINDER: AMP customers are not eligible for the Tiered Container or Tiered Urn offer. Any submissions for AMP customers will not be processed.

Additional Information (Optional)