BACKSTAGE FASHION, INC. C.O.D. AUTHORIZATION CHARGE FORM

Please note, we no longer accept COD's. This form is for customers who were on COD with us, previous to this policy change. 

If you would like your order shipped C.O.D., please fill in your credit card 
information below; sign and fax the form to us at: 928-443-0200. Thank you.

Business Name:______________________________

Card Number _____________________________________

Exp. Date ________________________________________

Name as it appears on card _____________________________________

Billing Address:

Street ____________________________________________________

City, State & Zip ____________________________________________

Phone # ___________________________________________________

I understand, accept and acknowledge that my credit card will be charged for any and all shipping costs incurred on any C.O.D. orders I place, which are undeliverable, refused or returned to Backstage Fashion, Inc. for any reason.

_____________________________________
Signature

_____________________________________
Date