Affiliate Payment Information Form

Get this form as a PDF download

Send to us: [email protected]

Click here to download

First Name

Last Name

Phone/Mobile

Company

URL

Social Media @ Name

Payment Method Selection

Please select your preferred payment method (choose one):

ACH Direct Deposit

PayPal

Mailed Check

For ACH Direct Deposit

Bank Name

Account Holder Name

Routing Number

Account Number

Confirm Account Number

Account Type

Checking

Savings

For PayPal

PayPal Email Address

For Mailed Check

Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Payment Threshold

Minimum payment amount before payout (default $50)

Certification

I certify that the information provided above is correct and complete. I understand that I must complete and submit a W-9 form (https://fabulousfrannie.com/w9-form) along with this payment information form. I acknowledge that Fabulous Frannie will file a 1099 form for me each year that I receive payments as an affiliate.I understand that this information will be used for payment purposes related to the Fabulous Frannie Affiliate Program.

Signature

Sign Here

Date