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Payout Form

Please fill out the following information for payout payments.

Mailing Address:

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Please Confirm full name and signature.

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I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Signed by Stephen Hall
Signed On: March 13, 2024

Timestamp

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March 13, 2024 1:09 pm CDT

Payout Form Uploaded by Stephen Hall - thecollectionarms@gmail.com IP 70.182.86.150