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Shipping

Payment

Remodeler Exclusive Send Agreement form

Signer First Name *

Signer Last Name *

Signer Phone *

Signer Email *

Address

Business Address *

Business City *

Business State *

Business Country *

Business Zip Code *

Business Legal Name *

Agreement Setup Payment *

setup payment 1 *

setup payment 2 *

per lead fee *

Triple check everything with the customer before submitting this form. Common mistakes are:

mispelling the email (read it to customer)
Adding wrong phone number
Not capitalizing and/or mispelling the contacts first/last name

If you select the wrong option for agreement setup payment they will be charged the wrong amount quadruble check it please. Example: If their agreement is the 3500 agreement the setup payment 1 and 2 should be $1750