TNS Diamonds Inc. SPECIAL ORDER FORM 109 S. 8th Street Philadelphia, PA 19106 U.S.A. 1-800-586-1792 Local(215)-922-1501 fax(215)922-2075 email - info@tnsdiamonds.com We accept PayPal - our accout is Payment@tnsdiamonds.com Sales Agreement for TNS Diamonds Inc. TNS Diamonds is not affiliated with Rolex, Cartier, or any other watch Manufacturer. Please print this form, fill out the blanks and fax to 215-922-2075. TO HELP FIGHT FRAUD please fax a copy of your Drivers license and Credit Card (front and back side) for orders over $250 I _______________ would like to special order __________________ for the amount of $________. I authorize TNS Diamonds to charge my credit card for the above amount. Detailed description of the merchandise. ________________________________________________________________________ ________________________________________________________________________ Credit card type______________ Credit card Numbers____________________ Expiration_____________ CVV2 #_______________ (Visa / Mastercard 3 digit number on back of credit card) (American Express 4 digit number found on front of card) Address to ship to... ______________________________________ ______________________________________ ______________________________________ ______________________________________ This shipping address must match the billing address of your credit card. Please sign name________________________ Date _________________ Please Print name_______________________ Phone # _____________________ Email ______________________ Notice - Special orders are not refundable. ***TNS Diamonds Inc. is not affiliated with Rolex or any other watch manufacturer. Adding diamonds to your watch may void manufacturer warranty. If you have questions please call 1-800-586-1792 Thank you, TNS Diamonds Inc.