Please debit my credit card (details listed above) for the purchase of a single user software license and registration code.
Signature: ...................................
Special Note: Responses from cardholders must be enclosed in an envelope to ensure that cardholder and card details are not visible while in transit. Also, I do not recommend that you send your credit card details via the internet. However, you can email me for a facsimile number or my PGP Public Encryption Key.