CREDIT CARD TYPE: CARD NUMBER: EXPIRES: MM/YY: / NAME ON CARD: SECURITY (CCV) No.: ITEM               FILE NUMBER       QTY           ITEM               FILE NUMBER       QTY TO CANCEL, SIMPLY CLOSE WINDOW WITHOUT CLICKING ON ‘SUBMIT’
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USE THIS FORM IF EFFORT TO USE PAYPAL’S SHOPPING CART FAILS OR ‘HANGS’. YOUR INFORMATION WILL BE TRANSMITTED AND SERVICED THROUGH A REGULAR TERMINAL IN 24 TO 48 HOURS AND A RECEIPT SENT TO YOUR EMAIL.