Society of Independent Gasoline Marketers Of America - SIGMA ...

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SIGMA - Regular Membership Application Company Name: _____________________________________________________________________________ Mailing Address: _____________________________________________________________________________ Phone: ________________________ Fax: ___________________ Email: ______________________________ Key Contact * _______________________________________________________________________________ SIGMA Sponsor (if any):________________________________________________________________________ *Key contact is the person in the company who will exercise the company’s voting rights and receive mailings that are restricted to one per member company. Please also list any additional company personnel that you would like to receive valuable SIGMA information (Weekly Report, legislative updates, newsletters, convention notices, etc.).

SIGMA Monthly Dues Schedule (Minimum monthly dues are $125.00) Note: Independent gasoline marketer companies vary greatly in size and type of operations. In an effort to spread SIGMA’s operating costs as equitably as possible among members, dues are structured so smaller companies pay less than larger ones. To be even more fair, “size of company” is measured both on number of outlets and on sales volume of motor fuel. Include all subsidiaries and controlled affiliates (over 50% ownership). (Retail outlets controlled equals the number of retail outlets where the SIGMA member, pursuant to a contract or otherwise, has the exclusive right to supply or designate a source of supply for that retail outlet.) 1) Half of dues based on number of outlets where you control the supply of motor fuel # of Outlets Over 5,000 4,001 to 5,000 3,001 to 4,000 2,001 to 3,000 1,001 to 2,000 751 to 1,000 501 to 750 201 to 500 151 to 200 126 to 150 101 to 125 76 to 100 51 to 75 41 to 50 26 to 40 0 to 25

2) Half of dues based on entire annual motor fuel volume (both retail and wholesale)

Monthly Dues $809.00 $765.00 $693.00 $603.00 $520.00 $462.00 $405.00 $318.00 $255.00 $203.00 $174.00 $156.00 $128.00 $116.00 $ 87.00 $ 62.50

Annual Volume Over 4 billion gallons 3,001 to 4 billion gallons 2,001 to 3,000 million gallons 1,251 to 2,000 million gallons 1,001 to 1,250 million gallons 751 to 1000 million gallons 501 to 750 million gallons 100 to 500 million gallons 75 to 100 million gallons 50 to 75 million gallons 35 to 50 million gallons 25 to 35 million gallons 15 to 25 million gallons 10 to 15 million gallons 7.5 to 10 million gallons 0 to 7.5 million gallons

Based on total number of controlled outlets of _________, monthly dues are:

Monthly Dues $809.00 $765.00 $693.00 $603.00 $520.00 $462.00 $405.00 $318.00 $255.00 $203.00 $174.00 $156.00 $128.00 $116.00 $ 87.00 $ 62.50

$ __________ +

Based on annual sales volume of _________ , monthly dues are:

$ __________ =

Total Monthly Dues

We prefer to be billed for and pay dues on a:

$ __________ x 12 = Annual Dues $ __________

 Semi-Annual Basis or  Annual Basis

I/We hereby apply for membership in SIGMA and certify that this company is not affiliated, through ownership, with a refiner. (Your first payment should accompany this application. If membership is declined, your payment will be refunded.)

Signature: ____________________________________________________ Date: ______________________ Please return to: SIGMA, 3930 Pender Drive, Suite 340, Fairfax, VA 22030 (703) 709-7000 fax (703) 709-7007 Note: Payments to SIGMA may be wholly or partially deductible as ordinary and necessary business expenses for federal income tax purposes but are not deductible as charitable contributions. Tax ID # 72-0562589

Key values of SIGMA membership:      

Network with the “best & brightest” at SIGMA - both branded and unbranded Access to the latest industry information with Weekly Report, IGM, legislative updates, website, legal memos, etc. Education that is requested by marketers, planned by marketers & presented in part by marketers Meet with all fuel suppliers in one place and get to know them all A loud & clear Legislative presence on Capitol Hill SIGMA counsel, Steptoe & Johnson, LLP 202-429-6222 – they can answer your questions & clarify laws all as a part of your SIGMA membership dues

Note: You can pay your dues by credit card if you prefer. Card number ____________________________________________ Exp. Date _______________________________________________ Name on card ___________________________________________ Amount ________________________________________________ Please return to:

SIGMA 3930 Pender Drive, Suite 340 Fairfax, VA 22030 (703) 709-7000 -- Fax: (703) 709-7007

SIGMA: America's Leading Fuel Marketers www.sigma.org