Referral Agent Sign-Up Form
Earn $100 per referral during tax season
Your details
Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
How Did You Hear About the Program?
Preferred Payout Method
*
Please Select
Paper Check
Cash (electronic method method - CashApp or PayPal)
CashApp or PayPal Username
Required if getting paid via CashApp or PayPal
Full Mailing Address
Required if getting paid via paper check
Bank Account Information (For Direct Deposit Only)
Routing
Bank Account Information (For Direct Deposit Only)
Account Number
Bank Account Information (For Direct Deposit Only)
Required if getting paid via
Do you agree to receive a $100 commission for each qualified referral?
*
Yes
No
Do you understand that a qualified referral is: -A new client who has not previously engaged the Company’s services.-A client who successfully completes the referred service and pays in full for the services rendered?
*
Yes
No
Do You Have a W-9 On File with Us? (Required for payouts over $600):
*
Yes
No
Upload Your W-9 Form
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Upload ID
*
Browse Files
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Choose a file
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of
Upload Bank Info Screenshot, CashApp username, PayPal username
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Referral Program Terms & Conditions:I have read and agree to the terms and conditions of the Prosperity Rose Tax and Financial Services.I understand that commissions are paid once the referred individual becomes a paying client or partner.
Signature
*
Continue
Continue
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