Gift Card Purchase Form

GIFT CARD PURCHASE FORM

Parties

Purchaser Name:

WHEREAS

WHEREAS, Purchaser wishes to acquire one or more gift cards issued by Issuer, subject to the terms and conditions set forth in this Form and any related issuance materials; and

WHEREAS, Issuer maintains the right to issue, activate and redeem gift cards and to set reasonable administrative procedures for issuance, delivery and redemption; and

WHEREAS, the parties wish to document the purchase, payment terms, delivery method and key legal provisions governing the gift card(s) purchased.

Gift Card Details

Card Type: Physical Card Electronic (e-gift)

Delivery Method:   Requested Delivery Date:

Scope of Work

The parties agree that Issuer will: issue the gift card(s) described above; activate card balances upon receipt of cleared payment; deliver physical cards or electronic codes in accordance with Purchaser's selected delivery method; and accept redemptions of the gift card up to the available balance as set forth in Issuer's standard redemption policy. Specific special instructions (if any) shall be stated below.

Payment Terms

Purchase Amount: $

Late Payment Fee:   Processing Fee (if any): $

Taxes: Purchaser is responsible for any applicable sales, use, value-added or similar taxes imposed in connection with the purchase of gift cards unless otherwise indicated by Issuer in writing.

Term and Termination

Term Start Date:   Term End Date (if applicable):

Either party may terminate this purchase agreement for material breach by the other party upon written notice and a cure period of days. Termination shall not relieve Purchaser of payment obligations for cards already issued or delivered in accordance with this Form.

Confidentiality

Each party agrees that non-public business information disclosed in connection with this transaction, including purchaser payment information and Issuer operational procedures, will be held in confidence and used solely for performance under this Form. Confidential information does not include information that is or becomes publicly known through no breach by the receiving party or is lawfully received from a third party without restriction.

Delivery, Acceptance and Refunds

Issuer shall deliver gift cards or electronic codes in accordance with the delivery method above after receipt and clearance of payment. Gift cards are non-refundable once issued and activated except where required by applicable law or as otherwise agreed in writing by Issuer. Purchaser must notify Issuer within 7 days of delivery of any failure to deliver or defects in physical cards.

Lost, Stolen or Damaged Cards

Lost or stolen gift cards will be replaced only in Issuer's discretion and upon receipt of reasonable proof of purchase and identity. Issuer may assess an administrative fee for replacement cards and may require an affidavit or other documentation prior to replacement.

Governing Law; Entire Agreement

This Form shall be governed by and construed in accordance with the laws of the state of without regard to conflict of law principles. This Form, together with any documents incorporated by reference herein at the time of issuance, constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior proposals, communications and agreements.

Acknowledgment and Certifications

By signing below, Purchaser certifies that Purchaser has the authority to complete this purchase and that all information provided in this Form is true and correct. Issuer certifies that it is authorized to issue the gift card(s) described and will honor redemptions in accordance with its stated policies, subject to applicable law.

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