To be eligible for a finder's fee, you must submit this form. It will automatically be date and time stamped and this information will be used to register your tips and referrals and to resolve disputes. If your tip requires considerable explanation, submit a brief description on-line and then call us with the details. You may submit multiple tips and/or referrals on the same submission form. All blocks on the form with an asterisk ( * ) next to them are mandatory fields. All finders' fees will be paid to you for furnishing Fox Ridge Services, Inc. with valuable information that directly results in the placement of an engineer(s) or CAD designer(s) with one or more of our clients in accordance with the provisions of the Fox Ridge Services, Inc. Tips and Referrals Program. Finder's fees may be taxable income (check with your accountant). We will issue you an IRS Form 1099 at the end of each tax year. We must have your Social Security Number or Federal Taxpayer Identification Number before we can pay you a finder's fee. You may either enter this information below or call it in to us after you submit this form. Acceptance of a finder's fee should in no way be construed as a contract of employment between you and Fox Ridge Services, Inc. *Name: *Mailing Address: *E-mail Address: *Work Phone: *Home Phone: SSN or TIN: *Date (month/day/year): *Referrers- O.K. to use your name?: Yes No Remember, you must enter contact information for each referral (either a phone number or the name and location of the company where employed). If your referral(s) is being submitted against a specific job listing(s) on our web site, include the job ID#(s) with each referral. Enter or cut and paste your tip(s) and/or referral(s) below:

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