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Support Order Form

LMR International, Inc.
Credit Card Authorization Form
for Support / Consultation

Cardholder Name:

Credit Card Number: CVV2 (Code on back) Exp Date:

Billing Address:

City: State: Zip Code:
(Address where monthly Credit Card statements are received)

Phone Number:
(Associated with Credit Card)

E-mail:

Being the cardholder or Corporate Officer, by signing below I understand and agree to the terms set forth in this agreement, agree to pay, and specifically authorize LMR International Inc. to charge my Credit Card, for support based on time spent with the developer during the support session:

I understand that I will be charged the amount of $150 per hour in 15
minute increments or fraction thereof.

I also understand that I am paying for the developer's time to assess and/or explain and NOT FOR RESULTS which, for obvious reasons, are unpredictables.

Comments:

FOR OBVIOUS REASONS THIS SALE IS FINAL. A REFUND REQUEST WILL NOT BE HONORED. ANY ISSUES MUST BE RESOLVED BETWEEN THE PARTIES. LMR INTERNATIONAL, INC. WILL DO ITS BEST TO PROVIDE REASONABLE REMEDY AS APPROPRIATE.

Signature Date:

8661 NW 24TH ST SUNRISE FL 33322-3301
Phone: (800) 713-0457 Fax (800) 708-0365

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Your legal name

Your email address

Please Confirm full name and signature.

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Timestamp

Audit

June 22, 2016 8:23 am EST

Support Order Form Uploaded by Lorenzo Rodriguez - Supportlmr@LMRinternational.com IP 98.160.203.104