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Mike's Fine Jewelry
2324 1st Ave. North
Birmingham, Alabama 35203
Toll Free Order Number: (800) 290-4478
Phone: (205) 251-0005
Fax: (205) 251-0030
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Jewelry Layaway
Contract
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This contract is
entered into between purchaser and Mike's Fine Jewelry for
layaway and purchase of certain jewelry as described herein
below. Purchaser indicates by his/her signature that
he/she has read and completely understands the
Layaway Terms and Conditions
and agrees to abide, and be bound, by same. Purchaser
acknowledges that he/she understands all the terms and
conditions of this layaway contract including finance schedules.
Purchaser further agrees and understands that any disputes
arising out of this contract are subject to the jurisdiction of
and in accordance with the laws of the State of Alabama, U.S.A.,
as per the legal
notice posted on this website.
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Customer
Information: |
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| Last Name: |
_________________________________________ |
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| First Name: |
_________________________________________ |
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| Address: |
_________________________________________ |
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| Address: |
_________________________________________ |
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| City: |
_________________________________________ |
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| State: |
_______________ |
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| Country: |
_______________ |
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| Zip/Postal
Code |
_______ -
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| Day Phone: |
(_______)
- __________________________ |
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| Evening
Phone: |
(_______)
- __________________________ |
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| Email
Address: |
_________________________________________ |
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Order
Information: |
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| Item # |
Qty. |
Description |
Size |
Price Ea. |
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Payment Method (Please circle one) |
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| Credit
Card |
Check or
Money Order |
Bank to
Bank Wire Transfer |
Western
Union or Money Gram |
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Special Instructions/Inscriptions |
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______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
I, by my signature below, hereby acknowledge that I have read
the Terms and Conditions of Sale for jewelry or other
merchandise I have placed on the layaway program. I
understand that I am responsible for payment of the initial
deposit and all handling and service charges. In the event
of nonpayment or cancellation, I understand that I forfeit all
monies paid to Mike's Fine Jewelry for said layaway
item(s). I further understand that I can, at any time, pay
this contract in full and/or accelerate the payment schedule.
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| Dated: |
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________________________ |
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| Print Full Name: |
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_____________________________________ |
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| Signature: |
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_____________________________________ |
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DO NOT COMPLETE THIS SECTION - FOR INTERNAL USE
ONLY: |
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| Date Contract
Received: |
_____________________________ |
| Payment Amount: |
$____________________________ |
| Received By: |
_____________________________ |
| Merchandise Pull
Date: |
_____________________________ |
| Layaway
Term/Special Instructions: |
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________ |
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