Technical Assistance Account Form

TRI Pension Services
Technical Assistance Account Form

I would like to establish a Technical Assistance Account with TRI Pension Services. I have provided the credit card information below and authorize TRI Pension Services to charge $100 to establish my account. I understand that none of this amount will be applied toward my technical assistance charges. My credit card authorization also authorizes TRI Pension Services to charge my credit card for monthly technical assistance charges and for the annual maintenance fee ($50) that is charged as of each anniversary of the establishment of my account. On a monthly basis, I understand that I will receive, at the email address shown on my authorization form, an e-mail that details the technical assistance charges for each month.

Fill out the form, print it and then: (1) fax it (303-470-0058), (2) scan it and send it by e-mail (or, in lieu of scanning, send all of the information below in the body of an email) to TRIPSconsulting@gmail.com, or (3) mail your order to:
    TRI Pension Services
    Attn: Technical Assistance Registration
    PMB 120
    9457 S. University Blvd.
    Highlands Ranch, CO 80126

Credit Card Authorization (all fields required)

Type of card
Name on Card:

Card Number:

Security code (on back of card, 3 or 4 digits):

Expiration date of card (must be at least 12 months after enrollment date):

Billing Address - Street:

Billing Address - Street(cont.):

Billing Address - City:

Billing Address - State: Billing Address - Zip Code:

Contact Telephone: Name of Your Company:

E-mail address:

I subscribe to the following publications offered by TRI Pension Services:

The ERISA Outline Book (available in hard copy or oneline)

ERISA Views (electronic newsletter)

eRISA Update (electronic newsletter)

None of the above (it is recommended that you subscribe to The ERISA Outline Book if you are enrolled for our technical assistance services)

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Last updated 6.3.2010

Type of card
Name on Card:
Card Number:
Security code (on back of card, 3 or 4 digits):
Expiration date of card (must be at least 12 months after enrollment date):
Billing Address - Street:
Billing Address - Street(cont.):
Billing Address - City:

Billing Address - State:		Billing Address - Zip Code:
Contact Telephone:		Name of Your Company: