PACIFIC COAST STAR
Fax: (509) 466-3475
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.
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. The customer agrees to all risks associated with shipping ítems internationally including, but not limited to loss during shipping. 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_____________________________________________________________________________