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To pay for eBay auctions using Visa, MasterCard, Discover, or American Express, please print this form, fill it out, and FAX it to (502) 452-2278. It is a good idea to call ahead because our voice and fax numbers are the same. Please retain a copy of this form for your records. If you have any questions, feel free to call Ed @ Hastie Studio, (502) 452-2278. I, ___________________________________________________________________________, authorize Hastie Studio (located at 1103 Julia Avenue, Louisville, KY. 40204), to charge the following Credit Card, # ________________________________________________, Expiration Date: ________________, the ONE TIME amount of $____________________ (US Dollars), for the following eBay items (please include the eBay Auction numbers): ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ I agree to the terms and conditions of this sale as stated in the eBay listing(s) and will also comply with the terms and conditions of my Credit Card issuer. I further agree that the merchandise is sold "as-is" and that there are no returns or refunds unless stated otherwise in the description of the item(s) on the eBay listing. Please ship my item(s) to: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Address where Credit Card is billed to (if different): ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ P.O. # (Purchase Order for Corporate clients only): __________________________ Name (as it appears on the card): _________________________________________________ My Telephone Number is: _________________________________________________ Signed, _____________________________________________________________ |