California:
1505 N. State College Blvd. Anaheim, CA. 92806
Ph: 714.776.5555 . Fax: 714.776.5556
» info@salvageantiques.com		 New Jersey:
246 Beacon Avenue, Jersey City NJ 07306 USA
ph: 201.222.6367 - fax: 201.222.6368
» info@amighini.net

 » CREDIT CARD FORM

» CLOSE  

If you wish to pay by Credit card, please download this form. Fill it out, sign it and send it back to us by fax at CA: 714-776-5556 * New Jersey: 201-222-6368.

Please complete your billing and shipping information to process your order.
Item #:  

Customer and Billing Information (where you recieve your CC statement)
First name: Last name:
Address :
City: State:
Country: Zip code:
Phone: E-mail:
Would you like to get a shipping quote? Y    N .

Credit Card Information
-Check your credit card
  MasterCard       Visa
Name as appear on the card:
Card Number:
Expiration date:
Verification Code Number:

Shipping information
-Check if same above:

First name: Last name:
Address :
City: State:
Country: Zip code:
I agree to purchase this/ese item/s and authorization to Amighini
to charge on my credit card the amount of $    (American Dollars).

Customer signature:.................................................................    Date:  

Privacy Policy

AMIGHINI is a secure site; your personal information will not be distributed or sold to others for any reason. Our privacy policy is simple: We don't sell, barter, give away, or rent your personal information to any company outside of AMIGHINI