EZ Local Service Agreement

EZ Local Service Agreement
E-Sign or Fax to: (877) 519-2378
Business Information
Business Name
Address

Address

Street Address Line 2

City State

ZIP
ZIP
Business Phone
Website
Business Email
example@example.com
(The email EZlocal will use to contact you. Internal use only
Owner Name
Online Presence Management
LOCAL - $169/mo.
SOCIAL $169/mo.
REPUTATION $169/mo.
WEBSITE $169/mo.
PICK 2 - $279/mo. PICK 3 - $369/mo. PICK 4- $469/mo
Set-up fee: $1,195.

Financing available.
Term of this Agreement is ONE (1) year. The undersigned applicant represents that all information provided by applicant is true and correct. If EZlocal accepts this application, applicant hereby agrees and accepts all Terms and Conditions posted at https://ezlocal.com/agreement and acknowledges that all applicable Agreements located there will govern the relationship with EZlocal.
PAYMENT FORM
WHEN ACCEPTED BY EZLOCAL, THIS WILL BE THE APPLICATION AND AGREEMENT.
EZLOCAL, INC. - 377 E BUTTERFIELD RD, SUITE 300, LOMBARD, IL 60148 -

PHONE: (877) 416-2378

E-Sign or Fax to: (877) 519-2378
The undersigned authorizes EZlocal to initiate and honor charges by the payment method indicated to: EZLOCAL, INC., 377 E Butterfield Rd, Suite 300, Lombard, IL 60148.

One-time Setup Fee will be charged with first billing occurring within three (3) business days of successful enrollment. For all monthly billing programs, applications dated PRIOR to the 15th of the month to be billed on the 10th of the month. Applications dated on or AFTER the 15th of the month to be billed on the 20th of the month.

EZlocal account maintenance fee of $100.00 will be charged per Section 16 of Terms and Conditions.

AUTOMATIC PAYMENT AUTHORIZATION: All Agreements will remain in effect until the company has received notification from me that it is to be terminated in such a manner as described in such Agreements. Agreements shall only be effective upon acceptance of this application by EZlocal.

I authorize EZlocal to initiate Automated Clearing House (ACH) debit entries to my account with the depository named above.
Business Name
Address
City, State, Zip
PRINTED NAME
TITLE
DATE

Month Day Year
Date
Signature
Payment Information
My Products
prev next ( X )
Online Presence Management
$ 1,195.00

Total

$ 0.00
CHECKING INFORMATION
Routing # (9 DIGITS)
Checking Account
Credit Card Information
Credit Card #
Card Expiration (MM/YYYY)
VISA MASTERCARD AMEX DISCOVER
Name (Cardholder or Bank Account Holder)
Billing Address

Billing Address

Street Address Line 2

City, State, ZIP
Phone Number
Email
example@example.com
CARDHOLDER or BANK ACCOUNT HOLDER
PRINTED NAME
Signature
DATE

Month Day Year
Date
APPLICANT (only if different from ACCOUNT HOLDER)
PRINTED NAME
Signature
DATE

Month Day Year
Date
EZLOCAL, INC. - 377 E BUTTERFIELD RD, SUITE 300, LOMBARD, IL 60148 - PHONE: 1 (877) 416-2378
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EZ Local Service Agreement

Business Information

Online Presence Management

PAYMENT FORM

CHECKING INFORMATION