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Order form

Please fill in the forms below to process your purchase. Cyber Source will include "FREE" UPS ground shipping with all orders over $500.00 within the continental United States. We will email your tracking number upon shipment. Orders under $500.00, International destinations or other shipping means will be quoted with each order. For these quotes on shipping, please fill out and submit the forms, we will email you with the quote and await your confirmation before completing the sale. If the credit card being used has an address of New York State, we will have to add 8% Sales tax to the price of your order.

 

QTY Part # Description

Use this area below to fill in your credit card information. Your information will be held in strict confidence. All fields are required. All requested cardholder information, refers to the cards statement mailing address, etc.

 
BILLING
Email Address

Credit card

Cardholder name

Cardholder Address

Cardholder Address

Cardholder City

Cardholder State

Cardholder Country

Cardholder Zipcode

Card number

Expiration date

 

SHIPPING
Shipping Method

Street address
Address (cont.)

City

State/Province

Zip/Postal code

Country

 

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Copyright � 1999 Cyber Source
Last modified: June 09, 1999
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