Manufacturer Release Form

Authorization Letter

To Whom It May Concern:

I have recently joined Entheos and hereby authorize to establish an Entheos associated account as the default bill-to party and process my future orders on such account.

I further authorize the deactivation and removal of any accounts I may have previously established, including with any buying groups or group purchasing organizations.

I have granted Entheos access to account management information on my behalf. Please provide to them at their request whatever information they may require to administer our relationship, including but not limited to: 1) duplicates of invoices, (2) refund and exchange confirmations, (3) account summaries, and (4) credit reports.

By my signature below, these arrangements shall remain in effect unless and until you receive written notification from me.