www.BuyVegasHome.com - Credit Card payment by fax

Please fax the form to: (702) 387-2649

I authorize Eastbiz.com, Inc. to debit my credit card for the total sum of: $_________

Check one: __ VISA __MasterCard __Discover __AMEX

Credit Card Number:

Name on the card:

Expiry date

Billing address (street, apt. #)

City

ZIP

State

I agree with terms of use.

Signature Of Card Holder______________________________ (Signature is required)

The payment is for services on www.ValuesInfo.com (www.Real-Estate-Values.com). Phone: 702-212-3513

Check one:	__ VISA __MasterCard __Discover __AMEX
Credit Card Number:
Name on the card:
Expiry date
Billing address (street, apt. #)
City
ZIP
State