PRINT, COMPLETE, SIGN & FAX TO (504) 300-0833

NationsPropertyBuyers.com
  
Phone: (504) 300-0611
Fax: (504) 300-0833




CASH REWARD PROGRAM REGISTRATION FORM

Name Home Phone (     )
Mailing Address Work Phone (     )
City                            State            Zip Cell / Pager (     )
Social Security # Email Address

ACKNOWLEDGEMENTS

I hereby acknowledge and agree that:

I am not an employee of NationsPropertyBuyers.com. Therefore, I am responsible for any income tax liability and for notifying the IRS of my earnings.

Either, NationsPropertyBuyers.com or I may choose to terminate my participation in the CASH REWARDS PROGRAM at any time and for any reason.

If I earn $600 or more during any calendar year, NationsPropertyBuyers.com will issue a 1099 IRS Form for tax purposes as required by law. Further, I will cooperate fully with the preparation of this form by supplying my Social Security Number to NationsPropertyBuyers.com as indicated above.


Signature
Date