Order Authorization Form
Mihr Beauty Babe!! Thank you for your order. Please fill out this form completely within 24 hours of placing your order. Failure to do so will result in shipping delays or order cancelation. AIl information entered MUST match what's shown on your order QUESTIONS? EMAIL MiHRBEAUTYBOUTIQUE@GMAIL.COM
This form acknowledges that the person listed below has authorized Mihr Beauty Boutique to process an order from them on the date mentioned below. The photo ID attachment is considered a formal and legal signature to authorize this transaction. This person also understands that in the event a fraud / any type of dispute is filed for ANY REASON this form will be submitted as part of a legal investigation and pursuit.
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Full Name (Listed on billing information / cardholder)
*
First Name
Last Name
Full Name (If name for shipping or order is different)
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Order Number & Order Date
*
example@example.com
Billing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Shipping Address (Leave blank if it’s the same as billing address)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I have authorized a purchase from Mihr Beauty Boutique, on the date and for the amount listed above.
*
Please Select
Yes
No
Does the billing / shipping address, phone number and email belong to the cardholder?
*
Please Select
Yes
No
Photo ID (CARDHOLDER)
*
Browse Files
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Choose a file
Cancel
of
Non payment plan payments.Please upload a photo showing the last 4 digits of your card & name
*
Browse Files
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Choose a file
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of
Signature
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