The document is a refund authorization form for Barbara Maness from The Real Estate Workshops. It lists her customer information including name, address, purchase date and refund amount of $5,000. It requires her signature to confirm acceptance of the refund for cancellation of her program and agrees to keep the refund amount confidential.

1.
DATE: 2/17/2017
RETURN PROCEDURE:
To expedite your refund from The Real Estate Workshops, please sign and return this form by fax and/or
by email:
Mailing Address: The Real Estate Workshops
12760 Park Avenue #1315
Riverton, UT 84065
Fax Number: 1­801­285­5660
Email: support@therealestateworkshops.com
Phone Number: 1­877­891­3046
CUSTOMER INFORMATION :
Name: Barbara Maness
Address: 220 N Glencoe
City: New Smyuna Beach State/Province: FL Zip: 32168
Date of Purchase: 1/09/2017
REFUND AMOUNT AUTHORIZED: $5,000.00
Explanation of Refund: Cancellation of Program
Customer’s Confirmation for Refund :
In response to my request, The Real Estate Workshops has offered to provide me a refund. I hereby accept
the above‐stated Credit Amount Authorized as refund in full for the program I purchased from The Real
Estate Workshops, or in refund for that specific porꬅon of the program and/or products returned herein. I
hereby release The Real Estate Workshops and its owners, employees, agents, associates and assigns from
any further responsibility or liability relaꬅng to my purchase and/or to that porꬅon of the program and/or
products being returned.
I confirm that this refund is confidenꬅal between me and The Real Estate Workshops and its affiliates. I promise
that I will not communicate with any person or enꬅty about the amount of the refund that I receive without
specific wriꬅen permission from The Real Estate Workshops. “Communicate” includes but is not limited to oral
conversaꬅons, leꬅers, emails, social media posꬅngs and all other forms of communicaꬅon. If I breach this
promise not to communicate about the refund, I understand that The Real Estate Workshops has the right to
cancel the refund and/or collect the amount of the refund I receive back from me as damages for my breach. I
agree that this refund authorizaꬅon shall supplement my original agreement with The Real Estate Workshop.
I understand that The Real Estate Workshops will begin processing the refund for the amount menꬅoned above
a韎�er I return a copy of this signed document to the company.
CLIENT SIGNATURE: ___________________________________________ DATE: _______________
DocuSign Envelope ID: 5384DB08-85D7-4B04-B7F9-F852220E9748