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| Instructions |
| 1. Please print and complete the form in its entirety. Incomplete forms will not be accepted. |
| 2. Send the form with a Self Addressed Stamped Envelope (SASE) to: |
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 RealtyStore.com |
| Attention: Customer Support |
| 5951 Encina Rd. Suite 206 |
| Goleta, CA 93117 |
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| Refund checks will be sent to the Address you provide below. Please allow 4–6 weeks for delivery. |
| If you have any questions, please send an email to support@realtystore.com or call 1–800–473–1783. |
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| Email: |
(Please use the same email address that you used when registering for the service) |
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| Phone Number: |
(Please use the same phone number that you used when registering for the service) |
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| Name: |
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| Address: |
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| Refund Amount Requested: |
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| Reason for Refund: |
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| Signature & Date: |
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| By signing above, I certify under penalty of perjury that I am a valid RealtyStore.com member in good standing and furthermore, I am eligible for a refund due to the reason(s) stated above. |
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