AUTHORIZATION TO DISTRIBUTE STORE FINANCIAL REPORTS

RSM McGladrey Financial Process Outsourcing Retail Accounting Services

RSM McGladrey Financial Process Outsourcing (“RSMM”) is committed to protecting the confidential nature of your financial data and reports. Your information is available only to RSMM staff and is safeguarded. The financial and statistical reports we prepare for you are compiled from data you supply to us and are intended for the internal use of store management. They are not audited or otherwise verified by us.

We also understand that you may want to take advantage of some of the support and advice available from your distributor, and may wish to authorize us to provide the distributor with copies of the reports we prepare for you. Due to the confidential nature of your reports, we need your written authorization to distribute copies of these financial reports. Any person that you authorize to receive these reports will be required not to make copies or otherwise distribute the reports or the financial information contained in them.

Please indicate your authorization of the following individuals to receive financial information by checking YES or NO after each one.

YES NO NAME

Division President ______

Sales Manager ______

Account Executive ______

Credit Manager ______

Tax Preparer (with address below) ______

Firm Name ______

Address ______

City, State Zip ______

Other (with address below) ______

Firm Name ______

Address ______

City, State Zip ______

Note RSMM is compiling benchmarking information that would allow us to compare your store’s financial performance to stores with similar characteristics (location, size, etc.). We request that you allow us to include your store data on an anonymous basis for this statistical analysis. If you consent to participate in this program, we will provide you with this benchmarking information in each report.

YES NO

RSMM Benchmarking Statistics ______(on any anonymous basis for statistical analysis)

This authorization remains in effect until replaced by a new, signed authorization form or rescinded.

Store Name(s): ______

Authorized By: ______

Title: ______

Date: ______