|
Dear Client,
Welcome to Hyman for Herbs! Thank you for ordering our products. Please take time to complete the following account authorization form. As part of our fraud prevention program, please fax this completed form to 1-419-715-2121 within 72 hours of your order. If you do not have access to a fax machine, please print this e-mail, complete the form, sign it, and then mail it to: Hyman For Herbs. You may also print, complete the form, sign it, scan it and send it as an attachment in an email to joel@hymanforherbs.com . 1. Our records indicate that you ordered our products using a credit card. Our fraud prevention measures require that you provide us with the card holder's name and signature. The card holder must sign and date the portion below or this authorization form will not be valid. (Stamp and electronic signatures are not acceptable.) Card Holder: _____________________________________ I authorize the use of my credit card, with the last four digits ____________, for payment of services with Hyman For Herbs. Please note, that not signing and/or completing this form does not remove your obligation to be bound by our policies, nor does it remove your obligation to pay for services rendered. Signed: _____________________________________ Date: ______________________________________ 2. Was everything about your order handled to your satisfaction?Yes No If you answered No, please provide comments on how we can improve your experience with Hyman For Herbs.
______________________________________________________________________ If you have any questions regarding this e-mail or your account, please send an e-mail to joel@hymanforherbs.com Regards, |