Client Information Page

Chin Purchase Information Form

First Name:

Last Name:

Street Address

City:

State:

Zip Code:

Home Phone:

Cell Phone:

Email Address:

Chin Number (If Known)

50 Percent Deposit Options

Add any additional information here

We Accept the following modes of Payment for Deposit:

1. Cash (Be cautious when mailingbe sure to email when sent and I will email you know when it arives)(Required at Pick-up Only)

2. United States Postal Money Orders Only!

(No Western Union or other Money order Companies)

2. Personal Check* (Deposit Only)Please email me when check is sent and I will email you when it arrives for security purposes)

3. Paypal* (please provide your billing email address and we will send you and invoice.)(*paypal service fee added to invoice)

That's it!

Contact us for exact pricing!

Deposits are 50% of Purchase The Price

*Make out check or money order & Mail to:

Fred Tartaglione

P.O. Box 1531

Rocky Point, NY 11778

*Please Note:

Deposits are non-refundable unless

previous arrangements have been

made in writing.

So please be sure of your choices.

Cinzia's Chinchilla Ranch