Refunds & Exchanges
AFFIDAVIT ATTESTING TO NON-USE OF IMAGE/S

 

 Your Name  
 Company Name  
 Billing Address  
ORDER INFORMATION (Available from your "Account" area at www.jupiterimages.com)
 Order Number  
 Date of Purchase    ___ / ___ / ___
 Billing Address  
PRODUCTS PURCHASED
 Image #'s  
 Circle one: 
600kb 1mb 10mb 28mb 56mb 72mb 129mb other
REASON FOR RETURN OF PRODUCT (Required)
 

I understand that by accepting a refund for the item(s) listed above, I am confirming the following: I and my employer are relinquishing all rights to possession and/or use of any of the single images listed above and/or all the images listed above; We are confirming we have deleted and/or otherwise destroyed any and all copies of the image(s) that we might have downloaded or made, be they electronic copies, printed copies, or copies of any other kind in any medium whatsoever; We further confirm that we have not conveyed copies of the image(s) to anyone else; We also acknowledge our understanding that should we retain and/or use and/or permit anybody else to use any of the image(s), we are in direct and willful violation of JupiterImage’s copyright(s) and we are therefore liable for actual or statutory damages as well as punitive damages. I confirm that I am authorized to agree to these terms and sign below.
 

AUTHORIZED SIGNATURE:  __________________________________ DATE:  ______________________
PRINT NAME:  __________________________________ PHONE:  ______________________
FAX COMPLETED FORM TO: 520-881-1841
JUPITERIMAGES     /    5232 E. PIMA ST., STE. 200C     /     TUCSON, AZ 85712     /    520-881-8101