SeductionExtreme.com Credit Card Registration Form

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

BACK
Photo copy of your ID 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.)

I here by authorized SeductionExtreme.com to bill my credit card for my current and future orders.    Sign here:____________

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 is lost or damaged during shipping.
Sign here:____________

Please bill me for Delivery Guarantee. If my order is lost in transit for any reason, SeductionExtreme.com will have to either replace the order or issue me a refund immediately. Sign here:____________

Please ship my 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:____________

Card Number: ______________________________              Expiration Date: ______________

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:_______________________