Order Authorization Form
Hello, thank you for your purchase! Please complete this form within 24 hours of purchase to avoid any shipping delays and order cancellations.
Disclaimer
To ensure secure transactions, Xplicit Hair Collection reserves the right to verify all orders by requesting valid identification and proof of payment. All information provided MUST match the information on the order placed on the website. This verification is solely used to protect our business from fraudulent activity and chargebacks. In the event of a fraudulent dispute, this documentation will serve as evidence to support and validate your purchase.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Order Date
*
Order Number
*
Order Amount
*
Billing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Shipping Address (If Different)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Photo ID (Card Holder)
*
Browse Files
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Choose a file
Cancel
of
By selecting "Yes", I have authorized this purchase from Xplicit Hair Collection on the date and for the order/amount listed above.
*
Please Select
Yes
By selecting "Yes", I verify that I am the authorized cardholder and approve this purchase.
*
Please Select
Yes
By signing this form, I understand and agree that this is a final sale, and I waive all rights to file a chargeback or dispute against this purchase with my financial institution.
*
By signing this form, I am agreeing to the store Terms of Service, Policies, and Conditions.
*
Print Name & Today's Date
*
Submit
Submit
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