PLEASE PRINT AND COMPLETE THIS FORM IN ITS ENTIRETY AND FAX TO

 678-391-3743

You cannot make a payment online from this web page.

Re: Property Address Where Consultation

to Be Performed: ___________________

Date and time of consultation request: _______________________

In the event that Client cancels appointment with less than a 24 hour notice, Client will be billed for one hour of labor at a rate of $125.00

This signed agreement must be received by Homes Designed To Sell prior to a representative of the company arriving to perform the consultation.

Payment/Authorization Information
Original Transaction ID	(not required for unlinked credits)*
ABA Routing Number	*
Account Number	*
Bank Name
Name on Bank Account	*
Bank Account Type	--Select One-- *
eCheck Type	--Select One-- *
Accepted Payment Method	American Express, Discover, MasterCard, Visa
Card Number	(enter number without spaces) *
Expiration Date	(mmyy) *
Amount	(i.e.,10.00) *
Authorization Code	*
Order Information
Invoice #
Description
Customer Billing Information
Customer ID
First Name
Last Name
Company
Address
City
State/Province
Zip Code
Country
Phone
Fax
Email

Privacy Policy: Homes Designed To Sell understands your desire to protect personal information. We intend to inform you how your personal information will be gathered, tracked or used.

We request personal information when you place an order, request a service, correspond with us or engage in certain other activities on our website. This information is collected and stored for use exclusively for the purpose of fulfilling actions initiated by you. Your credit card number passes directly through our credit card processing system as encrypted data and is stored securely within our system to prevent access from authorized site access. All access to senstive customer data is encrypted and dually protected against access.

Under no circumstances will your personal data, ordering habits or credit card information be leveraged as a product, distributed to a third party or sold.

Delivery Method: Services are performed at the requested residence from the client when an on-site consultation is being performed or via photos provided by the client when a web consultation is done at the client's request. Payment is due at the time services are rendered. In the event the client cancels the appointment without at least 24 hours notice in advance, a cancellation fee of $125 shall apply.

Return Policy - No returns, no credits.