Customer Purchase Receipt & Agreement – Care Next Technologies LLC

Customer Purchase Receipt & Agreement – Care Next Technologies LLC

Please complete this form to confirm your purchase, receipt, and agreement to the terms for cosmetic product sales.
Care Next Technologies Llc, 876 Curtis St 3806, Honolulu, Hi, 96813
Receipt Number
Employee Number
Order Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Full Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Billing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Is your shipping address different from your billing address?
Shipping Address (if different)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code

Order Details

Rows	Item	Quantity	Condition at Time of Purchase	Notes
1
2
3
4
5

Product Inspection Confirmation
Credit Card Last 4 Digits
I confirm I am the authorized cardholder and approve this transaction.
Customer agrees that carrier tracking confirmation constitutes proof of delivery.
Customer confirms products were received in good condition at the time of purchase or shipment.
All sales are final. No refunds. Exchanges allowed only within 14 days with receipt and original packaging. Cosmetic/skincare product results are not guaranteed and vary by individual. Customer confirms products were received as described. Shipping orders cannot be cancelled once processed. The company is not responsible for lost, stolen, delayed, or undelivered packages once shipped but will attempt to assist with carrier claims when possible. Customer agrees to contact the company directly to resolve any issues before filing disputes and acknowledges waiving the right to file a payment dispute or chargeback related to product description or delivery once shipment has been confirmed.
I have read and agree to the purchase terms above.
Customer Signature
Date Signed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Photo ID Upload (Optional, for fraud protection)

Cancelof
Should be Empty: