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All Customers Must Complete Payment Authorization Form

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Payment Authorization Form

Sign and complete is form to autorize YumYum Hair Collection to make a one-time debit to your account. Your signature on this form states that you gave us permission to charge your account for the amount stated below. (This is permission only for single transactions)

First name

Last name

Email

Date of Birth

Address

Upload ID

Upload File

Upload supported file (Max 15MB)

Transaction Amount

Your Signature

Thanks for submitting!

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Please allow a 48 hour response time.

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