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Moon View Aquariums

   Full cylinder

   1/2 cylinder

   1/4 cylinder

   3/4 cylinder

   Pillar hider cylinder

   Roman style

   Piano style

   Library style

   Seamless bow

   U-shape room divider

   High cube

 

Ocean View Aquariums

   Seamless bow

   U-shape room divider

   Half cylinder

   Corner

   Piano style

   Full cylinder

   3/4 cylinder

   Cube bow

 

Star View Aquariums

   Louvre styles

   Rectangle

   Screen aquarium

   Jellyfish aquarium

   4-Ultra cube

   Multi-purpose

   Super  custom

 

Grand View Aquariums

   Seamless bow

   Half cylinder

   Corner

   panoramic angle

   U-shape

   Cube

   Desktop

 

Table Aquariums

 

Feng Shui Aquariums

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AquaVim

Aqua Vim Corporation

54-08 46th Street, Maspeth, NY 11378

Tel: 718-433-2698

Fax: 718-433-4826

E-mail: Sales@4fishtank.com

E-mail: AquaVim@aol.com

 

                                    AUTHORIZATION TO CHARGE CREDIT CARD

 

I, ___________________________________, hereby authorize Aqua Vim Corporation

to charge my credit card in the amount of $_____________________________________.

Credit Card # ___________________________________________________________.

                        (16 digits V/MC/Discover or 15 digits for American Express )

Expiration Date: ___________________________(MM/YY)

CVV2# (last 3 or 4 digits of number located above the signature line on the back of card):  ___________.

Address associated with credit card statement:

__________________________________________________; State of ___________

Zip Code associated with credit card statement: _______________

(    ) Visa     (    ) MasterCard            (    ) American Express            (    ) Discover

This is one time only transaction associated with the enclosed merchant application.

Note: Your shipping address must be the same as billing address. If your shipping address is not the same as billing address, please pay by Paypal, or check.

                                                                                                                                    Thank you.

______________________________                        ________________________

Authorized Signer on Card                                     Date