Yes. I would like my website listed on Pricecheck.com. Please find my information below with signature by a signing authority of the Company as recorded.

Legal Name of Company _______________________________________________________________________________________________________________

Country where the world CEO resides________________________________________________________________________________________________

Brand and Operating Names of the Company_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Attach addiitonal brand names if necessary.

Industry Category(ies)  you would like your Company listed in___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Attach additional categories if necessary.

Website Addresses you would like listed________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Attach additional website addresses if necessary.

What country does your company(ies) listed pay taxes in ________________________________________________________________________________________________________________________________________Attach additional coutry taxes if necessary.

Contact name for listing management________________________________________________________________________________________________________

Contact email address for listing management______________________________ Contact phone number for listing management________________________________________________________

Listing application approved by;___________________________________________

                                                                       Signature of Signing Officer (Black Ink) ___________________________________________________________________Date_________________________

                                                                       Title______________________________________________Name of Company_____________________________________________________________________

 Contact email of Signing Authority.________________________________________________________Contact phone number of signing authority._______________________________________________

Please print this page. Scan and email to info@Pricecheck.com.  Subject. Listing Application for Pricecheck.com