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Opals International Jewelers,
Inc. dba CustomFineJewelry.com
7465 N.W. 23rd Street Bethany, Oklahoma 73008 USA
405-495-6610, 1-800-654-3259 or Fax 405-495-6611
Print this page, fill out below,
and fax to us 405-495-6611
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Date________________________
Credit Card#______________________________ Exp. Date
______________ CCV # (3digit on back near signiture
line)________
Full Name as on Card __________________________________________________________________
Billing Address _____________________________________________________________________
Shipping Address _____________________________________________________________________
Email Address________________________________
Phone Number ___________________________________
Signature ________________________________________
The above signature gives Opals International Jewelers,
Inc. permission to do an Authorization Only request
to secure $ ________________ for shipment of (products)
________________________________. I also agree to
return shipment in original condition minus any agreed
upon items to purchase within the 10 day time period
estimated
to be ______________________________________.
Print above page, fill out details, Fax to us
405-495-6611
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