SOURCE OF GOODS

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Billing Details

First name **

Last name **

Company name **

Country **

Street address **

Street address 2

Town/City **

State **

Zip **

Phone number **

Email address **

Password **

Re-Type Password **

By authorizing this transaction, customer agrees that Source of Goods may convert this transaction into an Electronic Funds Transfer (EFT) transaction and to debit customers bank account for the amount specified via ACH. Customer agrees to continuous monthly billing of membership and customer also authorizes to be charged for each and every order processed on their account. Additionally, in the event this EFT is returned unpaid, a service fee, as allowable by law, will be charged to this account via EFT or ACH. In the event you choose to revoke this authorization, please do so by contacting the merchant directly. Please note that processing times may not allow for revocation of this authorization. For credit card transaction as well, customer agrees to be debited monthly for the accepted cost of their membership as well as to be charged for each and every order processed through their account.

Monthly Subscription Payments: Credit Card ACH Account

Order Process Payments: Credit Card ACH Account

Please Note: If you choose to have your orders processed with a Credit Card There will be a 3% surcharge.

Would you like Orders to be processed by Credit Card untill your Account is verified? Yes No

Credit Card number **

Expiration Date **

Security Code **

Name on Card **

Routing Number for ACH **

Bank Account Number **

Please Verify your Bank Account Number **

Important Note: Micro-Deposit Verification. Source of Goods will initiate two micro deposits of less than $1.00 each to your linked bank account. This will be followed by one withdrawal for the total amount of the two test deposits. Once these deposits post in your account please verify the amounts on your user billing page. No orders will be able to be submitted until verified.

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Billing Details