Home-based Travel Agent Program Application

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Date of Application Submission(Required)

MM slash DD slash YYYY

Full Name of Applicant(Required)

Prefix First Last Suffix

Date of Birth(Required)

MM slash DD slash YYYY

Social Security Number (Enter, your SSN)(Required)

Social Security Number is required for Federal Income Tax Reporting

FEIN | Tax ID | Not-for-Profit ID(Enter your SSN, If you do not own a business)(Required)

Enter your Federal Employer Identification Number(FEIN). If you are signing your current business up as an Agent Affiliate or if income earned is going to be deposited into a business account. Otherwise, enter your SSN.

Personal E-mail Address(Required)

Enter Email Confirm Email

Current Primary Telephone Number(Required)

Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Current home address

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Future or Current Business Name(Required)

Please indicate your future travel agency name or website name

Business Address (If different from home address - if same enter home address)(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Enter business address - If

Business FAX(Required)

Business Phone (Displayed onto your website)(Required)

Have you booked Travel before now?(Required)

Yes

List your past experience in booking travel(Required)

What is your projected annual gross sales projections: $25K, $50K, $75K, $100K or more (Enter below)(Required)

Current Employed(Required)

Yes

Current Position

Current Employer Name & Telephone Number

SELECT YOUR WEBSITE DOMAIN WISELY: Private Labeled Website Name: Expl. YourFutureTravel.com - Select a name that everyone will remember because it will be forwarded from your private labeled sub-directory website. You can purchase a domain name from: www.getonlinewebhosting.com. They have outstanding rates and it is easy to point your private labeled website to your account.

What is your website domain name | Purchased from: www.GetOnlineWebHosting.com(Required)

Enter your Website Contact E-mail Address:

Telephone number to appear onto your website

Telephone System for Your Business: Telephone number for your clients to reach you. You can get a 1-800 for business and fax digital number via Ring Central. We are an authorized & certified dealer for your professional telephone service. We recommend using a professional telephone reception service program for your business telephone system/services. Therefore, we have established a partnership with RingCentral to provide you a discount on your telephone service & equipment. This service will position your home-based business as a premier company by having a professional telephone services. Contact us to get your account activated and equipment. Visit us online: www.personalizedservicesinternational.com/personal-services/business-professional-telephone-services/

CREDIT & DEBIT PAYMENT FOR SIGNUP AND ADDITIONAL SERVICES: Name on the credit card(Required)

Credit Card Number(Required)

Credit Card Security Code (Front of card for AMEX- Last 4) All others back of card to enter your last 3 digits(Required)

Card Type (Payment for your agent start up fee & charge back) - only select one card type(Required)

Visa

MasterCard

AMEX

Discover Card

This field is required so please check only one that apply to your form of payment.

Credit Card Expiration Date (if you card does not have an expiration DAY - it expires at the end of the month indicated on the card expiration anniversary month)(Required)

MM slash DD slash YYYY

Billing Address for credit card payment(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

* By completing this credit authorization above, Personalized Services International, LLC is authorized to charge this credit card for the amount specified and the cardholder waives all rights for credit card chargebacks. Do you authorized PSI, LLC to charge your credit card for Chargebacks?

Yes

IRS-1099 FORM REQUIREMENT: Understanding that you will be given and 1099 for the payments you receive from Personalized Services International, LLC for your Independent Booking Sub-Agent or Home- Based Agent Account. Do you AGREE to receiving a IRS-1099(Required)

Yes

You must complete a W-9 Form and agreed to receiving an IRS -1099 in order to receive your commission payments. The IRS requires us to give you a 1099 if your commission payments are $600.00 in a tax year; however, we will issue all sub-agent or agencies a 1099 regardless of your commission payment amounts. You must agree to this policy. Also, agree to complete this form within 30 days receiving your booking account and agent ID. Do you Agree to complete your W-9 within 30 days of you starting your agency!(Required)

Yes

SECTION 2: BACKGROUND CHECK AUTHORIZATION FORM - During the application process and at any time during the tenure of my sub-agent's affiliation with Personalized Services International, I hereby authorize Personalized Services International, LLC to procure a consumer report (known as an investigative consumer report in Illinois and California) for my sub-agent which may include information regarding credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, mode of living, or criminal background. This report may be compiled with information from credit bureaus, courts record repositories, departments of motor vehicles, past or present employers and educational institutions, governmental occupational licensing or registration entities, business or personal references, and any other source required to verify information that my sub-agent has voluntarily supplied. I understand that my sub-agent may request a complete and accurate disclosure of the nature and scope of the background verification, to the extent such investigation includes information bearing on his/her character, general reputation, personal characteristics or mode of living. Minnesota & Oklahoma Residents please note: In connection with this application as the sub-agent of a contracted Home Based Agent, this consumer report may be obtained and reviewed. Under Minnesota and Oklahoma law, sub-agent has a right to receive a free copy of this consumer report by checking the appropriate box below. You automatic agree to a background check by completing this application! Only select Yes or No if you resident in Oklahoma or Minnesota! (Background check - consumer report request)

Yes - Minnesota Resident

No- Minnesota Resident

Yes - Oklahoma Resident

No- Oklahoma Resident

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SECTION 3: CREDIT CARD, COMMISSION & WEBSITE AGREEMENTS: Limited Power of Attorney: I am an Independent Booking Agent/Agency (IBA) or Home-Based Agency/Agent (HBA) of Personalized Services International, LLC in the Travel Agency Division. I hereby appoint Personalized Services International, LLC this power of attorney to charge the monthly expenses incurred by my IBA sub-agent during the course of selling travel through Personalized Services International, LLC. Charges may include, but are not limited to: delivery fees, 24 hour reservation service, ticketing fees, GDS monthly fees and terminal server fee, as well as any amounts owed, including invoices or tickets issued on accounts receivable, debit memos incurred as a result of my IBA sub-agent's use of the GDS, and charge backs by my IBA clients. This "Limited Power Of Attorney" shall remain in full force and effect until terminated by me in writing, such termination to be effective only with respect to charges occurring after the time that the written termination is delivered to Personalized Services International, LLC, ATTN: Travel Agency Division, 8522 Terracotta Place, O’Fallon, IL 62269. I understand that Personalized Services International, LLC will provide details or such charges on my Commission Payment Report of via letter upon my request.

Do you understand the information in this section? Yes and agree

No, I do not understand or agree

Do you need additional information?

Yes, send me more information

Do you understand the information in this section? Yes and agree No, I do not understand or agree Do you need additional information? Yes, send me more information I also understand that the credit card in this application will be charged each year based on my IBA or HBA anniversary date for the yearly renewal fee associated with being a Independent Booking Sub-Agent (IBA) or a Home-Based Sub-Agent (HBA) with Personalized Services International, LLC and its affiliates. Personalized Services International and its affiliates will automatic charge your credit card on file 30 days prior to the charge date. If we are not able to successfully credit or debit your credit card on file your accounts with our company will be suspended until payment is made. This authorization applies to any of the credit cards you as the IBA or HBA chooses to keep on file with Personalized Services International, LLC for any business transactions performed during our joint affiliations.(Required)

Do you understand the information in this section? Yes and agree

No, I do not understand or agree

Do you need additional information?

Yes, send me more information

Independent Booking Sub-Agent: Your credit card will be charge for your start up fee upon the receipt of your application and it is non-refundable 24 hours after we receive your application & payment! Your credit card will be charged again for your website upon the completion of your background check AND you will become a Home-Based Agent (HBA)! If you do not want a private label website please indicate below. By checking the box below you agree to the conditions of the IBA and/or the HBA Travel Agency Program. I agree to be charged $100 for my private labeled website by the company contracted by Personalized Services International, LLC?(Required)

I Agree

I do not Agree

I Agree I do not Agree Do you want a Private Labeled Website? If so, you will be charged $100 fee for the setup. If you select yes - your credit card will be charged this fee immediate!(Required)

Yes

I do not desire to receive a private labeled website. Therefore, I will only use the resources of Personalized Services International, LLC Travel Agency Division accounts and no private labeled website will be assigned to my company. You will be given an IBA account. By your selection below you digitally sign and agree to this bending agreement. However, you can select to have a private labeled website if you change you mind in the future!(Required)

Yes

Note: If you elect to receive a private labeled website you agree to commission split with the company providing the website and Personalized Services International, LLC. I agree to the commission split of 50% of all travel booked on my private labeled website. This is the fee for having this website to increase my business. I Agree to the private labeled website commission split.(Required)

Yes

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Logo Design for your website: Rectangular logos with a maximum size of 200 x 75 pixel are best. Acceptable file types are .ais, .eps, .jpg, .gif, .tif, .psd or .pdf. You will be able to upload your logo to your website. If you need a custom logo for your company let us know. We have an agreement with several design companies that can get this done for you at a reasonable cost and they are professional. Or, we can have it done in house. Normal logo designs cost is $200.00

Do you have a logo?

Do you need a logo designed for your company?

SECTION 4: IDENTITY VERIFICATION: You must submit with your application a copy of a legal form of ID issued by the Federal or State Government Agency (Driver Licence/State ID/Military ID…..etc)(Required)

Do you agree to submit you verification? - Yes

Do you agree to submit you verification? - No

Check only one that you agree to above!

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SECTION 5: LIABILITY AGREEMENT - LIABILITY AREA MUST BE SIGNED IN FRONT OF A NOTARY OF YOUR STATE, CITY OR COUNTY - You must download the Addendum to this application and have it signed and submitted with your application. Your application will not be approved without this documentation! Addendum is located on the Travel Agent page on www.YourFutureGroupTravel.com and www.PersonalizedServicesInternational.com(Required)

I Agree to completed the Addendum to this application

I do not Agree to complete and sign the Addendum to this application

SUBMISSION OF REFERENCES HELP US DETERMINATION OF YOUR ACCOUNT APPROVAL - REFERENCES CAN NOT BE FAMILY MEMBERS!

Name of Reference 1(Required)

Prefix First Last Suffix

Phone (Cell or Home)(Required)

Email(Required)

Enter Email Confirm Email

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Name of Reference 2(Required)

Prefix First Last Suffix

Phone (Cell or Home)(Required)

Email(Required)

Enter Email Confirm Email

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Name of Reference 3(Required)

Prefix First Last Suffix

Phone (Cell or Home)(Required)

Email(Required)

Enter Email Confirm Email

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

What date do you want to start your new business venture?

MM slash DD slash YYYY

SECTION 6: CUSTOMER CREDIT CARD AND PERSONAL INFORMATION PROTECTION - Personalized Services International, LLC is not liable for IBA or HBA collecting payments from customers via credit cards, debit cards, checks or cash and applying these payments to their customer’s travel arrangements. It is our policy that no IBA/HBA shall keep their customers credit card payment information on file via paper or in their personal or business computers; due to the fraud and hackers. Each IBA/HBA is liable to protecting their clients personal and credit information. They shall book travel direct with the provider of travel using the client’s form of payment (Credit or Debit Card). It is not recommended that you take cash payments for travel due to this liability and you will be charge the credit card processing fee when you purchase your client travel. If you want your commission payment direct deposited into your bank account submit our Direct Deposit Form and a VOIDED check with your application(Required)

Request Direct Deposit - Yes

Request Direct Deposit - No

I Agree to the Credit Card Protection

I DO NOT Agree to the Credit Card Protection

Check all that applies to you and that you agree or do not agree!

Emergency Contact Name

Prefix First Last Suffix

Phone(Required)

Emergency Contact Email(Required)

Emergency Contact Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Billing Address (If it is the same as your home address please enter it again here)(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Name of Applicate: Entering your name in this box this represents your official online signature. Your signature confirms that you agree to all the term and conditions inside this document and the addendum you will complete separate of this application. You application will be submitted immediately to our company for full consideration. You are welcome to contact us direct for any additional questions, comments or concerns.(Required)

Prefix First Last Suffix