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Order Form
If you would not like to order online then print this page, fill it out and fax it our office: 800-353-5020
You can also mail in the form to:
Sarah Blake Inc
7345 S. Durango Dr. # B 107-168
Las Vegas, NV 89113
Order Details: (Please write below what you are ordering)
Credit Card Authorization Form
I, ___________________________________________ , hereby authorize SB INC, to charge my credit card account in the amount not to exceed: $____________________
( ) VISA ( ) MasterCard
Credit Card Number: _______________________________________________________
Expiration Date: _____ /______
VID Code(3 digit code on back of card): ____________
Credit Card Billing Address:
Street: _____________________________________________________________
City:
State: _____________
Zip Code: ___________ - _________
Country: (if not US) _________________________
Telephone: ( ) _____- _________
Email Address to notify you of your order status:___________________________________
Requested Shipping Address:
Street: _____________________________________________________________
City:
Zip Code: ___________ - _________
Country: (if not US) _________________________
Telephone: ( ) _____- _________
As the credit card holder, I hereby authorize receipt of goods & services at the shipping address above.
___________________________________________ ____/____/______
Cardholder’s Signature Date
Authorization Valid Until: ______ / ______ Initials Here: _______________
Your completion of this authorization form helps us to protect you, our valued customers, from credit card fraud. SB INC will keep all information entered on this form strictly confidential.
