PRINT, COMPLETE, SIGN & MAIL TO THE ADDRESS BELOW

www.WayneStephens.com
(888) 912-FAST or 888-912-three-two-seven-8
4655 Cass St. Ste 200
San Diego, CA 92109
 




CASH REWARD PROGRAM REGISTRATION FORM

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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 www.WayneStephens.com. Therefore, I am responsible for any income tax liability and for notifying the IRS of my earnings.

Either, www.WayneStephens.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, www.WayneStephens.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 www.WayneStephens.com as indicated above.


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