Reward Program Application

Please complete as many lines as possible, sign, and return by fax or mail.

First Name: ______________________                                    Last Name: _____________________

Address: _______________________    City: _________________    State: ______    Zip: __________

Phone #: (____) ____-______      Cell or Pager #: (____) ____-______    Email: ___________________

Social Security #: _____-____-_____

Acknowledgements

I hereby acknowledge and agree to the following:

I am not an employee of Affordable Realty of Ohio, LLC.

I am aware that I am responsible for any income tax due on money I earn, and I am also responsible to report to the IRS any income earned under this program.

If I earn over $600 in a calendar year, Affordable Realty of Ohio, LLC will issue an IRS form 1099 as required by law.

I will supply my Social Security Number above to be used for the Form 1099.

This agreement may be cancelled at any time by Affordable Realty of Ohio, LLC, or myself, for any reason, by simply notifying the other party in writing, on paper or via email.

____________________________                                   ___________
Signature of Participant                                                        Date

When completed, please return by fax to (440) 884-3627

Once received, you will be notified by email of your acceptance. In the email will be a special link. This link will be your link to submit property information for potential deals. Please save this link in your favorites as it can not be duplicated or retrieved.