ORDER FORM - for Collecting Insurance in Full
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Please print and RETURN this portion
If printer does not print, or you don't have a printer, send your name, address and EMAIL ADDRESS (legibly) and mail to the address below.
Send:
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| Paypal
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YOUR PERSONAL CHECK WELCOME !
Please Note: When ordering different topics ebooks you may use this SHOPPING CART APPLICATION or using Paypal Shopping Cart.
To those paying by Paypal no need to send us the filled Application because Paypal will notify us of your order and your details.
For orders outside USA please send international Money Orders only payable through a USA Bank
Your co-operation is very appreciated
To:
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 Gold
P.O. Box 2202
Hollywood, CA 90078 |
| If by using your information I cannot collect Insurance in Full every time, I am entitled to my money back. |
| Enclosed is $33 for Collecting Fully on Insurance Claims. (REf.erasebc.com) |
| Enclosed is $2 extra for priority handling. |
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