PACIFIC
COAST STAR
Phone: (509)466-3410
Fax: (509) 466-3475
info@pacificcoaststar.com
www.pacificcoaststar.com
Credit
Card Authorization Charge Form
Autorização de
debito no cartão de credito
Autorizacion de
debito en la tarjeta de credito.
No Refund / Não
devolução/ No devolucion.
I_____________________________________________AUTHORIZE
PACIFIC COAST STAR TO
(Your name / Seu nome / Su nombre)
CHARGE MY VISA____MASTERCARD___ (check one) ACCOUNT#_____________________________ EXPIRATION DATE________________
FOR TOTAL AMOUNT
OF US$ _____________________________________________
I ___________________________________________________________________
ACKNOWLEDGE THAT THIS AMOUNT
IS THE VALUE OF
THE PRODUCTS QUOTED BY PACIFIC COAST STAR AND NOW BEING ORDERED. I WILL BE
FULLY RESPONSIBLE FOR ANY
INCONVENIENCE OR FRAUDULENT INFORMATION WHICH WILL CAUSE THIS TRANSACTION TO BE VOID.
|It
is your responsibility
to understand the following: You will notice
there have been no shipping charges added to
your order. Since shipping rates to these
areas change so frequently all shipping costs will be added to
the card you provided us
only at the
time the product ships. This charge
will appear as a seperate charge on your card.
All shipping cost are non-refundable. If you wish
to know the amount of shipping
before the product ships, it is your
responsiblility send us an e-mail with
your name and order number,
and we will
e-mail with the cost. The cost
of shipping is determined by the rates of
the carriers. Once we send you
the shipping costs, you must
notify us within 24hrs if you do not want the order
to ship. If you feel the
shipping charges are too high, we will
be happy to cancel your order. If you do not contact
us within 24 hrs or before
the product ships (whichever is shorter), you
(the customer) agrees to all
risks and charges for shipping.
It is at
Pacific Coast Star's sole descretion to ship
products outside of the 48 states.
We may cancel an order at any
time if we feel there is
unnecesary risk involve for any
reason due to providing this
service. If you do not agree
to the above
you must notify us within
24 hrs of the purchase time.
____________________________________ __________________
AUTHORIZED
SIGNATURE
DATE
ASSINATURA COMO NO
CARTÃO DATA
FIRMA COMO EN SU
TARJETA FECHA
ADDRESS WHERE YOU RECEIVE YOUR CREDIT
CARD INVOICE / ENDEREÇO ONDE RECEBE SUA FATURA DO CARTÃO DO CREDITO /
DIRECCION DONDE RECIBE SU FACTURA DE
TARJETA DE CREDITO_____________________________________________________________________________
______________________________________________________________________________________