Directory Listing Setup Fee

We do not accept credit/debt cards.

For Paypal send $20 to thumphrey@dbsinstall.com.

For Check Payment; Please mail this completed form with a $20 check, payable to:

Todd Humphrey
808 Dunlop Ave, Sedro Woolley, WA 98284

Contact Information
Name
Company Name
Contact E-mail address for billing issues
Billing Address 1
Billing Address 2
City       State       Zip
Phone number of billing address	( ) -

By signing this form you understand that Todd Humphrey makes no guarantee, either written or verbal, that your listing in the locator and directory shall result in customer leads. Todd has operated the online directory since the summer of 2003, however makes no guarantee as to the duration of operation of the DBSinstall web site and the dealer / technician locator. Once your company information has been included in the locator, it is your responsibility to verify the accuracy of all information displayed in the locator and directory, including, but not limited to: Contact Information, Zip code, Products / Service provided and desired search results. Signature ___________________________________ Date _____      Fill in form before you Print