DUFF.NET
Secure Site Order/Payment Form
Difficulty using payment form? Contact us at 813-926-TELA or E-Mail us.
Checks accepted from clients paying by the year.
Paying by check? Complete and submit this form but mail payment to address at bottom.
Site becomes active when check clears... Credit Card orders activated immediately.
Billing Address
Street
Apt/Box
City/ST/Zip
Must Be The Same As Your Credit Card Address
If Not An Incorporated Business.
Web Site: www.duff.net +
/ /
duff.net E-Mail:
Day Phone:
Night Phone:
For Business Customers Only:
Employer Tax ID#
Contact:
Forward your (duff.net) EMail to:

(Current email address)
Cardholder's Name:
Credit Card/Check?
Credit Card Number

Card Expiration Date: (MM/YY)
Personal/NonCommercial Clients Business/Commercial Clients
Monthly Plans
Web Site Only - $13.00
EMail Only - $8.00
Web Site & EMail - $17.00
Annual Contracts (¼Payments OK)
Web Site Only - $78.00 ($6.50/Month)
EMail Only - $48.00 ($4.00/Month)
Web Site & EMail - $102 ($8.50/Month)
Note: Dial-up Service NOT Included
Monthly Plans
Web Site Only - $39.00
EMail Only - $ 16.00
Web Site & EMail - $47.00
Annual Contracts (¼Payments OK)
Web Site Only - $312.00 ($26.00/Month)
EMail Only - $96.00 ($8.00/Month)
Web Site & EMail - $360 ($4.00/Month)
Note: Dial-up Service NOT Included
Sum from choice above $ Sum from choice above $
Additional Storage on Server
(Above 200Kb in 200Kb Increments)
Monthly Plan
#Increments x $3 = $
Annual Contract
#Increments x $1 x 12 = $
Additional Storage on Server
(Above 500Kb in 500Kb Increments)
Monthly Plan
#Increments x $8 = $
Annual Contract
#Increments x $4 x 12 = $
Sub Total from above $
Additional FTP charges$
Web Building$
Other Charges$
Total Charges$
Sub Total from above $
Additional FTP charges$
Web Building$
Other Charges$
Total Charges$
By submitting this form you agree to pay the above
total amount according to your card issuer agreement.
Seal
All credit card information submitted using this form remains confidential with the use of a Secure Socket Layer Protocol. You can be assured this form is secure by noticing the solid key at the bottom of this form.
Help fight internet fraud. Never give credit card or social security numbers when solicited. When ordering online, make sure you only deal with merchants offering secure site protocols. If you suspect illegal dealings on the internet, contact the National Fraud Information Center web site or call them at 1-800-876-7060, a project of the National Consumers League. Another option is to contact your local FBI office.

Copyright ©2001 by Duffey Cybercations
813.926.3065 or 813.391.3065 (cell)
13014 Royal George Avenue
Odessa, FL 33556-5713