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American Bill Money (ABM) ~ Secure A Second Income... Not A Second Job! Simple, Affordable, Profitable!


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AMERICAN BILL MONEY NEW CUSTOMER SIGN UP FORM

NEW CUSTOMER ORDER FORM

I WAS REFERRED BY ABM CUSTOMER # 2996
#
I WAS REFERRD BY ABM CUSTOMER NAME (OPTIONAL)
HOW DID YOU HEAR ABOUT AMERICAN BILL MONEY?
ADVERTISEMENT
BROCHURE
PHONE CALL
POSTCARD
OTHER
NEW CUSTOMER INFORMATION
NAME
ADDRESS
CITY, STATE, ZIP
PHONE
FAX
EMAIL ADDRESS
PICK ONE

DELUXE CUSTOMER, $125/MONTHLY - PLEASE SEND ME 150 INCOME OPPORTUNITY SEEKERS NAMES AND
ADDRESSES ON PEEL-N-STICK LABELS AUTOMATICALLY EACH MONTH.

BASIC CUSTOMER, $75/MONTHLY - PLEASE SEND ME 75 INCOME OPPORTUNITY SEEKERS NAMES AND
ADDRESSES ON PEEL-N-STICK LABELS AUTOMATICALLY EACH MONTH.
VA RESIDENTS WILL BE CHARGED 5% SALES TAX.
METHOD OF PAYMENT (PICK ONE)
VISA
MASTERCARD
AMERICAN EXPRESS

DISCOVER
DEBIT CARD

ONLINE CHECK (FILL OUT CHECK FORM BELOW)
CREDIT CARD NUMBER
EXP. DATE
CVV2# (ON BACK OF CARD) EXAMPLE
CARD HOLDER NAME
CHECK HERE IF BILLING ADDRESS IS SAME AS ABOVE
BILLING ADDRESS
CITY, STATE, ZIP
ONLINE CHECK FORM

CHECKS WILL BE VERIFIED BY PHONE WITH YOU AND YOUR BANK.
NO SAVINGS ACCOUNTS ACCEPTED.

NAME AS IT APPEARS ON THE ACCOUNT
DOLLAR AMOUNT OF CHECK
BANK NAME - CITY - STATE
9 DIGIT ROUTING NUMBER EXAMPLE
ACCOUNT NUMBER (USE "-" FOR ANY SPACES)
YOU MUST AGREE TO THE FOLLOWING TERMS
CHECK THE BOX TO AGREE TO OUR TERMS
SIGNATURE 1
TYPING YOUR NAME ABOVE IS CONSIDERED A LEGAL ELECTRONIC SIGNATURE
OPTIONAL CUSTOMER AFFILIATE REFERRAL PROGRAM
ABM OFFERS A FANTASTIC 1-TIER AND 2-TIER REFERRAL PROGRAM FOR OUR CUSTOMERS
WHO CHOOSE TO HELP US ADVERTISE FOR NEW CUSTOMERS.

• If you are a “Basic” Customer, we will pay you $50 each month for each “Basic” or “Deluxe”
customer you refer to us.

• If you are a “Deluxe” customer, we will pay you $50 each month for each “Basic” or “Deluxe”
customer you refer to us, plus $25 each month for Every Other “Deluxe” customer infinitely wide
and infinitely deep according to pay plan. Plus 30% discount on additional marketing materials.

IF YOU WISH TO PROMOTE ABM YOU MUST AGREE TO AND SUBMIT THE AFFILIATE REFERRAL
FORM BELOW ALONG WITH THIS CUSTOMER ORDER FORM.

YES, I AM A CUSTOMER (YOU MUST CHOOSE ONE)

I AM BASIC AND I CHOOSE TO BECOME AN AFFILIATE AT NO EXTRA CHARGE,
PLEASE SEND 75 FREE 4X6 POSTCARDS WITH MY MONTHLY ORDER.

I AM BASIC AND I CHOOSE TO BECOME AN AFFILIATE AT NO EXTRA CHARGE,
PLEASE SEND 40 FREE BROCHURES WITH MY MONTHLY ORDER.

I AM A BASIC CUSTOMER AND DO NOT WISH TO BE AN ABM AFFILIATE.

I AM DELUXE AND I CHOOSE TO BECOME AN AFFILIATE AT NO EXTRA CHARGE,
PLEASE SEND 150 FREE 4X6 POSTCARDS WITH MY MONTHLY ORDER.

I AM DELUXE AND I CHOOSE TO BECOME AN AFFILIATE AT NO EXTRA CHARGE,
PLEASE SEND 80 FREE BROCHURES WITH MY MONTHLY ORDER.

I AM A DELUXE CUSTOMER AND DO NOT WISH TO BE AN ABM AFFILIATE.
YOU MUST CHECK THE BOX TO AGREE TO OUR AFFILIATE TERMS
CHECK THIS BOX TO AGREE TO OUR AFFILIATE TERMS
SIGNATURE 2
TYPING YOUR NAME ABOVE IS CONSIDERED A LEGAL ELECTRONIC SIGNATURE
DATE
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