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Download the form above, fill it out and return to us via fax or submit it through our Contact Us page after you have completed and signed the form.
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Download the form above, fill it out and return to us via fax or submit it through our Contact Us page - please make sure you include a faxed copy or scan of a blank check with the completed form.
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Fax Your Check Fax: 954-527-1191 |
Mail Your Payment PO Box 350430 Ft. Lauderdale, FL 33335 |
