Print Order Form - Intercept Investigations

PRINT THIS ORDER FORM

CUSTOMER INFORMATION
NAME
BUSINESS
ADDRESS
CITY, STATE & ZIP/POSTAL CODE
DAY PHONE ( ) _______ - __________ EVENING PHONE ( ) _______ - __________
EMAIL ADDRESS ______________________________ @ ______________________________
DELIVERY ADDRESS: [ ] RESIDENCE [ ] BUSINESS NO POST OFFICE BOXES!
PAYMENT INFORMATION
CREDIT CARD # __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __
AMERICAN EXPRESS # NOTE: We do NOT currently accept American Express cards
EXPIRATION DATE __ __ / __ __
NAME EXACTLY AS IT APPEARS ON CREDIT CARD _________________________
SECURITY CODE ___ ___ ___ SEE INSTRUCTIONS BELOW
CUSTOMER SERVICE TELEPHONE ON BACK OF CARD (______)______-_________
[ ] CASHIER CHECK / MONEY ORDER ENCLOSED [ ] BANK WIRE TRANSFER SENT
EQUIPMENT ORDER
ITEM #	DESCRIPTION	QTY	COST	TOTAL
			$	$
			$	$
			$	$
			$	$
SELECT SHIPPING METHOD
[ ] $15.00 FedEx Ground [ ] FedEx 3-Day [ ] FedEx 2-Day [ ] FedEx Overnight
International: [ ] Global Express Mail (3 - 5 days) [ ] Airmail Parcel Post (4 - 10 days)
SHIPPING, TAX & TOTALS
SUB-TOTAL			$
(See S & H Information Below) SHIPPING			$
NEVADA RESIDENTS ADD SALES TAX			$
TOTAL			$
BY SIGNATURE BELOW CUSTOMER ACCEPTS ALL TERMS & CONDITIONS
SIGNATURE (Required):

SECURITY CODE INSTRUCTIONS

Visa, MasterCard, Discover & American Express cards contain a security code that helps protect you from fraudulent use of your account. Since these numbers are never recorded on any retail receipt, Intercept Investigations uses them to ensure that the person submitting the order has actual physical possession of the credit/charge card. The practice of obtaining these numbers is a common and standard industry security practice to assist with the prevention of credit/charge card fraud.

The security code for Visa, MasterCard & Discover credit cards is found on the signature side of the card, inside the signature block. The last 3 numbers constitute the security code.

Visa, MasterCard & Discover Security Code