[MOPED WORLDŽ CARD-BY-FAX ORDER FORM]




If you are ordering a Moped, Scooter,
Mini-Scooter, or any other "Motorized Product,"
you must also do this:

 


TAPE A PHOTOCOPY
OF YOUR CARD
HERE
Sign----> X________________________
Cardmember hereby agrees to perform the obligations set
forth by the cardmember's agreement with the issuer.

 

FAX TO:
1-800-464-6928

Or if you wish...

MAIL TO:
MOPED WORLDŽ SALES DEPT.
P.O. Box 27034
Greenville, SC 29616
USA