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Text File  |  2001-01-06  |  400 b   |  31 lines
  1. You have entered the following information:
  2.  
  3. Your credit card billing will show a transaction from eSellerate Fulfillment on [DATE] in the amount of $[PRICE].
  4.  
  5. Click in the Next button to place your order. To correct any information, click in the Back button.
  6.  
  7. Name:
  8.  
  9. E-mail:
  10.  
  11. Company:
  12.  
  13. Phone:
  14.  
  15. Address:
  16.  
  17. City:
  18.  
  19. State/Province:
  20.  
  21. Zip/Postal Code:
  22.  
  23. Country:
  24.  
  25. Card Number:
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  27. Expiration Date:
  28.  
  29. Quantity:
  30.  
  31.