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If you have talked to me and would like to Send a Deposit in on a feature litter

Please print this form and mail it to me.

This deposit is for a Male____________ Female___________ puppy.

If paying your reservation deposit will a credit card Please feel in this part.

Date: ______________________

I, ______________________________________, hereby expressly authorize Shorkie World, to charge my credit card in the amount of $250.00 for a non-refundable reservation deposit payment of a Shorkie puppy & $12.50 For the 5.0% (Example 5.00 per 100.00 paid with card. You Must ad this in to the payment or I an not run the card.) the Convenience Fee For a total of $262.50

Credit Card Information

Name as it appears on Credit Card: _____________________________________

Circle the type of Credit Card: Visa Master-card

Credit Card Number: ______________________

Expiration Date: ______________ CSV#____________

Billing Address

Street: ________________________________

City: _________________________________

State: ________________________________

Zip Code: _____________________________

Phone: _______________________________

By executing this document, I expressly waive any right, which I may have to a refund, chargeback, or other form of return of the above charge amount. I Understand I will NOT be credited back on my

Credit Card account for any reason if I cancel the sale, or are dissatisfied with purchase. I will get refund any money charged by check or store credit when proof of refund is deemed necessary. Buyer's acceptance of any animals agrees that this transaction was consummated within the state of Missouri and consents to the application of all Missouri Laws and to the the jurisdiction of Missouri Courts. Should a dispute arise out of this transaction. Buyer further agrees that should he default in any obligation of this agreement, he shall be responsible for all attorney fees and court costs involved in the prosecution of this action. Acceptance constitutes An agreement to pay the above listed price and totals, with in agreed terms.

If no sex of puppy is available from the mom you choose with in 12 months your deposit will be refunded to you or you may have the choice hold it over for the next litter, or choose another mom. If there is only one sex of puppy born you must take that baby or lose your deposit. If several sex puppies are born you must pick your baby no more then 7 days after the pictures are put on our web site. We must receive another 250.00 after the puppy is born and you pick you baby. We must receive this by the time the baby is 14 days old. If you don't pick a baby with in the 7 days the next in line will have first choice. The date your deposit is received determines your order of pick. Please be aware we do not manufacture dogs, we are at the mercy of nature and therefore cannot guarantee delivery by any specific date. This deposit is only refundable if we cannot supply you with a puppy with the sex you stated in this form from the mom you want with in 12 months. If you elect to pass on a litter that is available to you, your deposit becomes non-refundable. After you talk to me you can mail this form to , Shorkie World