Georgia Home Buyer - Cash Reward Program Registration Form

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Georgia Home Buyer
We Buy Real Estate in Georgia
Atlanta, GA 31145

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 Georgia Home Buyer. Therefore, I am responsible for any income tax liability and for notifying the IRS of my earnings.

Either, Georgia Home Buyer 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, Georgia Home Buyer 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 Georgia Home Buyer as indicated above.

Signature

Date