Shipping Authorization Form

Serenity Designs
AbsoluteCorsets.com
PO Box 692
Jupiter FL 33468

Fax # 270.209.1714

AbsoluteCorsets.com Shipping Authorization

This document is for your protection and ours. If you do not wish to complete this form, the following options are available:

1) Send money order or cashiers check
2) Receive package at your billing address
3) Contact your bank and have them list a secondary address on your account.

We appreciate your cooperation in preventing online credit card fraud and for helping to make the web a safer place to shop. Failure to adhere to this policy will result in the delay and/or cancellation of order.

(EXCEPTION: options above are not applicable for international addresses, Authorization form must be received as address verification is not verifiable through international banks via phone).

Date:__________________________________________________

Order #:_______________________________________________

Cardholder Name:________________________________________

Billing Address:___________________________________________________________________

City/State/Zip/Country:______________________________________________________________
(address on file with credit card company)

Phone Number:__________________________________________

E-mail Address:__________________________________________

Alternate Shipping Address:

Shipping Address:_____________________________________________________________________

City/State/Zip/Country:__________________________________________________________________

By signing this form, I certify that I am the true cardholder and hereby authorize AbsoluteCorsets.com c/o Serenity Designs to bill the following credit card for merchandise cost and applicable shipping charges in the amount of $____________. I further authorize shipment to be made to an address other than my billing address (if applicable). Signing this form also indicates that I have read and understand the terms of sale, including shipping, delivery and return policies as outlined on the web site.

Visa______ MasterCard______ American Express______ Discover Card______
(please check one)

*Card Issuing Bank's phone number:____________________________
(for verification purposes - printed on back of card or credit card statement)

Card Number ________________________________Expiration _____/_____

Cardholder Signature: x___________________________________ Date: __________

PLACE FRONT OF                                         PLACE BACK OF
CREDIT CARD HERE                                CREDIT CARD HERE
    Must be light and legible                                Must be light and legible

COPY OF DRIVERS LICENSE
OR PHOTO I.D. HERE
Must be light and legible

FAX TO: 270.209.1714 / International Customers: +001.270.209.1714
Web site: http://www.absolutecorsets.com/
E-mail: Sales@AbsoluteCorsets.com