USPages.net, Inc. DATABASE REGISTRATION FORM


The USPages.net, Inc. stock offering has concluded. The USPages.net, Inc. stock issuance was the Internet's first legitimate offer of free registered Company stock and our offering was registered with the securities regulators in 27 states. If you are one of the thousands of people who earned a share, we thank you for your interest and support. You may continue to access your shareholder account and manage your contact information and stock certificate requests. If you were not able to register for a free share of USPages.net, Inc. Common Stock and would like to be notified in the event that an additional USPages.net, Inc. stock offering is registered, you may use this form to leave contact information.

You are under no obligation to purchase USPages.net, Inc. services. You may remove yourself from the database at anytime by following the instructions at the bottom of this form.

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Note: To remove yourself from the USPages.net database at any time, enter your Email Address and your Password above, then also enter the word "REMOVE" (in uppercase) in the First Name field and click the SUBMIT button.