FRONT
Photo copy of your credit card
(Show card # and exp. date)

 

 

BACK
Photo copy of your credit card
(Show signature)

 

I hereby certify that I am an adult of legal age in my Country/State/Community and I am the legal owner of the above credit card.  I accept the following terms that I sign: (Please strike out the terms that you do not agree to.)

  1. I here by authorized Tricon Interactive, Inc. to bill my credit card for my current and future orders at the Amazingtails Gift Store.
    Sign here:____________
  2. I don't need Delivery Guarantee. I will pay for the order in the event that it is damaged, lost, or confiscated by my local customs due to my country's import compliance. I will file an insurance claim with the shipping carrier directly if my order iss lost or damaged during shipping.
    Sign here:____________
  3. Please bill me for Delivery Guarantee. If my order is lost in transit for any reason, Tricon Interactive, Inc. will have to either replace the order or issue me a refund immediately.
    Sign here:____________
  4. Please ship my DVD/VCD order in the original manufacturer packaging.  I fully understand my country's import compliance, rules and regulations.  I will pay for the order if it is confiscated by my local customs.
    Sign here:____________

Credit Card Type:  1. Visa    2. Mastercard   3. Amex

Card Number: ______________________________

Expiration Date: ______________

Order Number: ______________
Name & billing address as shown on credit card statement:

Name:      __________________________________
Address:   __________________________________
                __________________________________
                __________________________________
                __________________________________
Authorized shipping address 1:

Name:      __________________________________
Address:   __________________________________
                 __________________________________
                __________________________________
                __________________________________

 Authorized shipping address 2:

Name:     __________________________________
Address:  __________________________________
                __________________________________
                __________________________________
                __________________________________


Signature: ________________________     Date:____________________________