MEMBERSHIP DUES PAYMENT PLAN

For the convenience of our Primary members we are offering this Payment Plan.

REALTORS® must be paid in full on or before January 4, 2017

Membership Dues can be paid in Full with Amex, Visa or MasterCard at Simply log in and follow instructions. Dues can also be paid in person or by mail with check, Amex, Visa or MasterCard. Cash payment accepted in person. DUES ARE NON-REFUNDABLE.

** FOR PRIMARY MEMBERS ONLYGPAR is offering a 6 part PAYMENT PLAN, only available with a credit card.

By signing below you authorize GPAR to charge the payments on the dates listed below to your Credit Card.

Payment #1 August 10, 2016$89.17

Payment #2 September7, 2016$89.17

Payment #3 October5, 2016$89.17

Payment #4 November9, 2016$89.17

Payment #5 December7, 2016$89.17

Payment #6 January4, 2017$89.15

Optional RPAC$35.00 ___(x here if you wish to make Contribution.)

If you participate in the payment plan and sign up any time after the first scheduled payment, you must make up any prior scheduled payment(s).

Contributions are not deductible for income tax purposes. Contributions to RPAC are voluntary and are used for political purposes. The amount suggested is merely a guideline and you may contribute more or less than the suggested amount. You may refuse to contribute without reprisal and the National Association of REALTORS® or any of its state associations or local boards will not favor or disfavor any member because of the amount contributed. 70% of each contribution is used by your state PAC to support state and local political candidates. Until your state PAC reaches its RPAC goal 30% is sent to National RPAC to support federal candidates and is charged against your limits under 2 U.S.C. 441a; after the state PAC reaches its RPAC goal it may elect to retain your entire contribution for use in supporting state and local candidates.”

GPAR Member #: ______NAME: ______

OFFICE NAME: ______

NAME AS IT APPEARS ON CREDIT CARD (IF DIFFERENT) ______

ADDRESS WHERE CREDIT CARD STATEMENT IS RECEIVED ______

CITY: ______STATE: ______ZIP CODE: ______

CARD TYPE: VISA/MASTERCARD/AMERICANEXPRESS - EXP. DATE: _____/____ CIS: ______

CREDIT CARD #

I certify that I have read and agree to the above terms.

______

Signature of Name on Credit CardDate

Please mail or fax completed form to the Finance Department at 215-423-0406.

1341 N. Delaware Ave., Suite 200, Philadelphia, PA 19125

Subject to established GPAR privacy policy.