Payment Authorization Form
Please submit this completed form after placing your order. All orders must have this form completed within 2 hours of order being placed. You will be asked to upload a photo of your ID.
Name
*
First Name
Last Name
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Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Proof of Identification
(Driver's License or Government ID)
File Upload
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
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Last 4 digits of card used to make purchase
*
Signature
Submit
Submit
Should be Empty: