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Release Of Information To Pay-Less Furniture And Appliances: (Please Read Before Signing)

The Information I(we) have provided on this form is correct. I authorize confirmation of all information that I(we) have provided. Pay-Less Furniture And Appliances may contact any person or company that is listed above, and I(we) fully release all parties from all liability from any damage that may result. My(our) Signature(s) below indicate that, for the purpose of confirmation, I(we) have voluntarily waived the protection of all rights to privacy laws. I also agree to accept messages from Pay-Less Furniture And Appliances regarding special sales or product offers via US mail, voice, email or text, and understand that I may opt-out at any time. This order may be rejected if any information provided above is found to be false.

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