Pest Control Service Agreement

Address Information
If your service address is the same as your billing address, you only need to fill out the customer information. Then, select ‘Same’ below.

Customer Information
First Name:
Last Name:
Address Line 1:
Address Line 2:
City:
State:
Zip:
Phone:
Email:
Srv Addr:SameDifferent

Service Address
Name:
Address Line 1:
Address Line 2:
City:
State:
Zip:
Phone:

Pests Included
Pests marked with an asterisk (*) are included in the basic service. You may select additional options for an extra charge.

Target Pests:
Ants*Spiders*Rats*Mice*Wasps*Cockroaches*Silverfish*Crickets*Earwigs*Pillbugs*Sowbugs*SnailsBeesFleasCarpet BeetlesFliesGophersStored Product PestsOther

Reg Initial Cost:

Discount (First Service):

Initial Charge:

Periodic Charge:

Warranty (Months):

Date:

Time:

Card Information:
Your card won’t be charged now and is not required for payment. By submitting, you authorize us to charge the card in case of nonpayment. Your payment info is securely stored. You can also sign up for autopay below and save $5.00 on your services!

I/We hereby authorize Traffic Pest Solutions to proceed with the selected pest control services. This service agreement covers only the pests specified above and does not include termites, fungi, or other wood-destroying insects. The service is subject to terms and conditions, including rights under the Federal Truth in Lending Law. The agreement is valid for 12 months and can be canceled with 30 days’ written notice. Any discount received for initial service will be charged back if canceled before the contract term. Payment is due upon presentation of the invoice. Thank you!

I confirm that I intend to sign this document electronically and consent to the use of an electronic signature for this transaction.

Once you have completed the form and checked the confirmation box, a submit button will appear, allowing you to send the form. Please click it only once. After submission, you will receive a copy by email.

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Pest Control Service Agreement

Industry