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Home
Regions & Blends
Must Read
About Us
A Test Above The Rest
Terms Of Service
Contact
Platinum Members
Platinum Payment
Platinum Application
The Do's & Don'ts Of Using A Debit/Credit Card For Kratom
Try it Thursday!
Re-leaf LLC
Payment
*
Indicates required field
Name
*
First
Last
Email
*
Phone Number
*
Order Number
*
ORDER NUMBER & TOTAL MUST BE ACCURATE!
What Was The EXACT Total On Your Order? (Final Total w/Shipping)
*
Do you give permission for us to charge your card the total of this order?
*
Yes
No
**Please double check all the information you put on this form.
DO NOT SUBMIT THIS FORM WITHOUT BEING 100% SURE OF ALL THE INFORMATION.
Card Holder Name
*
Credit Card Number
*
CVV/CVC
*
Expiration Date
*
Zip Code Associated With The Card
*
I am aware that this card will be charged and that the cardholder will see "Miracle Plant Mix" on the statement for this order. I will also refrain from calling this product "Kratom" when speaking to any financial entities. I am aware that this company is not selling this product as "kratom" for human consumption. Also, anything I do with this product is of my own accord and I will not ask Re-leaf LLC about ingesting this product. I have read the "Read" section that details the current struggles faced today when processing payments. I agree to all this info.
*
Yes I Fully Understand
No Please Contact Me To Explain This
Order
Home
Regions & Blends
Must Read
About Us
A Test Above The Rest
Terms Of Service
Contact
Platinum Members
Platinum Payment
Platinum Application
The Do's & Don'ts Of Using A Debit/Credit Card For Kratom
Try it Thursday!