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Complete this form to authorize American Home Services, Inc. to make weekly debits to your credit card or checking account listed below. You will receive an invoice every Monday, indicating how many leads you received and the total amount you owe for the previous week. We can credit your account for any leads that have invalid addresses, phone numbers or bogus names. (We reserve the right to audit the credit request to verify the information).
By signing this form you give us permission to debit your account for the amount of the invoice on each Monday. This is permission for a single weekly transaction only, as agreed upon, and does not provide authorization for any additional unrelated debits to your account.

The cost for the leads will be $12.00, $25.00 or $58.00 each. Cost is determined by the potential value of the lead provided. Service Leads, single windows, Garage Doors and repairs will be $12.00, Landscaping and Fencing type leads will be $25.00. Siding, Windows, Roofing, Basements, Bathrooms and Kitchen type leads will be $58.00 each. Exclusive Leads are $120.00 each.

I­ authorize American Home Services, Inc. to charge my credit card account or bank account indicated below on each Monday following the weeks my company receives business leads.

Please complete the information below:

  • Contact and Payment Information

    (Do not check these boxes if you don't want to pre-pay for ten leads.) *You will receive a 25% discount every time you pre-pay for ten leads.
  • I authorize American Home Services, Inc. to charge the account(s) indicated in this authorization form according to the terms outlined above. This payment authorization is for the goods/services described above and for the amount indicated on the weekly invoice only. I certify that I am an authorized user of this credit card or bank account. Any Invoice unpaid will result in immediate interruption of leads, until invoice is paid. Lead Return Policy You may return leads for credit for the following reasons: 1. Disconnected Phone Number 2. Blatantly erroneous information (ex: Mickey Mouse, Santa Claus.) 3. Duplicate Leads 4. Not The Homeowner *All other reasons for lead credit requests will be examined on a case-by-case basis. You will be informed by email of our decision. We reserve the right to audit your request as part of our lead investigation. All credits will be applied on your next weekly invoice.
    * Indicates Response Required
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