deSignet International Shipping Release Form

Fax To: 800-777-6256
Attention: deSignet Shipping Staff

Thank you for your purchase.  For security reasons we require the following information in order to ship to an address other than your billing address.  Please fill out and fax back at your earliest convenience.  Please type or print legibly, it is important that we correctly read the information in order to insure timely and accurate delivery.

This release form must be received at least one week prior to your scheduled ship date to ensure proper delivery.  If the customer changes the shipping address after the order is shipped (while in transit with UPS) the customer is responsible for all transfer and address change fees levied by UPS.  These additional charges will be billed to the customers credit card.

Business:  __________________________________________________ (if applicable)

Name:  ____________________________________________________ 

Address:  __________________________________________________ 

Floor, Suite Number or Apartment Number:  _______________________ 

City:  _____________________________________________________ 

State:  _______________________  Zip:  ________________________ 

Phone Number:  _____________________

I give my permission for deSignet International to ship my jewelry purchase to the above address. 

Signature of purchaser:  __________________________________________________ 

Printed name of purchaser:  _______________________________________________ 

Date:  _________________________ 

Sales Person:  ___________________ 

If you should need to contact us please use one of the following:
Phone:  888-727-8266
Fax:  800-777-6256
Mail:  deSignet International
1869 Whitehaven Road
Grand Island, New York, 14072