Order Verification

Please fill this form to verify your purchase. If you wish not to fill out, 
we can send you a PayPal Invoice for your purchase.
No PayPal account is needed for you to complete your purchase.

Why we ask for this?
We are in agreement with our merchant provider to verify 
customers using their payment method provided. 
Please understand it is for YOUR and OUR security.

 

THIS SUBMISSION IS CONFIDENTIAL AND FOR INTERNAL USE ONLY. ALL SUBMISSIONS ARE ENCRYPTED AND NOT STORED IN OUR SYSTEM.