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CONTACT INFORMATION

 *First name:
 *Last Name
 *Email
 *Password
 *Confirm Password
 *Address
 *Address 2
 *City
 State:
 *Zip
 *Phone
 *Type

WEBSITE INFORMATION & DEMOGRAPHICS

 *Website Name
 *Website URL  *Confirm Website URL
 *Brief description of website:

Website Categories: (choose up to THREE categories)




Family




Health




Other


No. of unique visitors per month:
 

No. of unique visitors per month:

Visitor Age: (check all that apply)








PAYMENT INFORMATION
IMPORTANT: Please read the information in this section carefully and ensure that the information you enter is correct. Failure to do so may unnecessarily delay commission payments to you

 *Make Checks Payable to:

WSTraderâ„¢ By Federal Law, WSTrader'sâ„¢, is required to maintain Taxpayer Identification Numbers (TIN) for U.S. persons and firms to whom WSTrader™ makes disbursements. The number you provide MUST correspond to the payee you have identified above. For individuals, this number is your Social Security Number (SSN). For other entities, it is your Employer Identification Number (EIN)


 *Taxpayer Id No:

*Required of all U.S. residents. Enter your nine-digit Tax ID number with no dashes

 Taxpayer ID No. Type:
*Required of all US Citizens.
 Tax Classification:
*Required of all US Citizens.

 *Owner's Name:
*For Sole Proprietorships only

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