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Secure payment form

Personal Details
Products:	Dynamic Submission, Dynamic Web Ranking, Dynamic Link Promoter (up to 10 domains)
Company Name:
Your Name:
E-mail:	(Avoid Free email Accounts)
Verify E-mail:
Address:
City, State, Zip:
Country:
Telephone:
Fax:
Your Homepage URL:
Comments:
Please provide your Client ID# if any	(Client ID# can be found in your Order Confirmation email)

Credit Card Details
Cardholder Name on Card:
Cardholder Address:
Cardholder Phone Number:
Bank Name:
Card Type:	Visa MasterCard AMEX Diners
Card Number:	CVV:
Expiry Date (mm/yy):	/
Purchase Amount:	US$150.00

Security and Agreement

Security Alert! The geographic location of your computer and your IP address has been logged, credit card fraud is a felony punishable by heavy fines and jail time. We cooperate fully with all agencies involved with preventing and investigating online credit card fraud. Crime on the Internet does not pay! We investigate each and every order, and report every fraudulent attempt to the authorities and applicable ISP(s).

Free Email Address: Due to the increase in credit card fraud originating from free, web-based, or email forwarding services such as yahoo.com, hotmail.com, juno.com, usa.net and over 1,000 others, we no longer accept orders from these anonymous domains. Please use your "real" email address provided by your ISP when filling out this form. If you have any questions about, or problems with this policy please contact us.

Please Click here to read the Agreement, and select check box before submitting your order.

I have read and Agreed

It may take several minutes to process your order, please press ONCE only (Please contact
if you do not hear from us 24 hours after submitting your order)