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1. Customer Information
Company Name
*
Your Name
*
Phone Number
Email
*
2.Payment Identification Information
Paying On
*
Account
Specific Invoice
Invoice Number
*
Ex. 1001,1002,1003,1004..
Payment Currency
*
KYD
USD
Total Amount
*
3.Card Information
Type Of Card
*
Credit Card
Debit Card
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*
Card Number
*
Card Holder Name
*
CVV Number
*
Card Expiration
*
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Notes
I authorize Beach Living Cayman Islands to charge the credit card indicated in this form according to the terms outlined that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company;so long as the transaction corresponds to the terms indicated in this form.
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