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for Your Participation in
CashGenerator.Org

Name ____________________________________________________
Address _________________________________________________
City    _____________________  State __________  Zip _______
Phone  ____________________    E-mail _____________________
Choose any 4-Digit Security Password _____________
(very important!)

Method of Payment:

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 Money Order*
 Cashier’s Check*

 MasterCard
 Discover

 Visa
 AmEx

Credit Card # _______________________  Exp. Date __________
Security Code # __________ 
(last three digits in the signature box on the
back of your credit card)
Signature ____________________________

*Amount: $350 payable to
CashGenerator.Org

Three Easy Ways to Order:

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by Credit Card, call: 541-924-9024

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or Fax this application to: 541-924-9026

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or Mail this application to: CashGenerator.Org
  1257 NW Highway 20  Albany, OR 97321

© 2007 CashGenerator.ORG
All Rights Reserved

Last Update 8/1/07

These people are beginning to improve their financial status. Join us by adding your name to this list and make your dreams come true!

#1  Jordan D. Smith, M.D.
#2  Jennifer Johnson
#3  Laura Reid
#4  Karen Bourne
#5  Robyn Howard
#6  Tyler James

07-1058
07-2079
07-3419
07-4603
07-5205
07-6085

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Thank You!

Questions? Contact Plan Administrator, Dave Smith  Phone: 541-924-9024

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