January 4, 2009

I , _______________________________________________________________,

authorize McKenzie Appraisals, Inc. to charge my credit card for the appraisal on

the property at _____________________________________________________.

I understand that this is for a service and can not be refunded.

Amount: $__________

Visa: _______ MasterCard: ________ Discover: ________ (Please Check)

Credit Card Number: ___________________________________

Expiration Date: _________________________

Billing Address for Card: __________________________________________

Last 3 digits on the back of the card: ___________

Signature: ___________________________________

Printed Name: ________________________________