Signature Page

Independent Contractor

associated with

Freedom of Choice Realty Inc.

FUTHERMORE:   In accordance with IRS tax compliance regulations, I certify, under penalty of perjury, that my Social Security number shown below is correct and that I am not subject to any backup withholding.

Social Security # ____________________        

Real Estate Lic.# _____________

Print your name: _________________________________________

Residental address: _______________________________ City: ___________

State: _______    Zip # __________ Phone # (_____)________________

Mailing address: __________________________________
                         (if different than residential address)

State: _________   Zip # ___________

      ______________________________________________           ______________
       (Associate's Signature)                                                Date

REV.2006