Print this form, fill it out clearly, sign it and send it with your order to:
Discount Duplication, 240 Oxmoor Circle, Suite 102, Birmingham, AL 35209
State _________________ Zip ________________
Phone ( )_________________________
If Paying by Credit Card Circle Credit Card Type
|American Express Discover Mastercard Visa|
|Account#_________________________________||Exp. Date________||CVV Code________||Signature______________________|
Video conversion rate: $14.99 up to 2 hours.
PAL Tape to NTSC DVD | PAL DVD to NTSC DVD
NTSC Tape to PAL DVD | NTSC DVD to PAL DVD
____________tape or disc converted to disc __________Length of Video.
______________________ Country tape was made
______________________ Country tape is to be viewed in
*dvd-r's are not guaranteed to play on the older dvd players. We are unable to refund payment due to incompatibilities with DVD Players **NO DISNEY PLEASE**
Please read and sign. I authorize the above stated work to be performed. I understand that I am responsible for any royalties which may be due, for obtaining permission to duplicate any copyrighted materials, and for the total content of the finished duplication. I do not hold Discount Duplication, Inc. liable for anything that should happen to property left due to mechanical, technical, fire, flood, or natural disaster. If paying by credit card, I authorize the charges for this service including shipping and handling to be charged to my card. If copyrighted tape, I have purchased and own this video for home use only. Please convert this tape for viewing on my tv.
Authorized signature__________________________________________________ Date_____________
Follow this link if you would like a Shipping Label for your Package Shipping Label Link