AGE VERIFICATION FORM

April 10, 2010 | By forms examples | Reply More

Age verification forms are used in situations where applicants’ age is of paramount importance. They may be used in online stores which deal with liquor or cigarette sales. They may also be used in adult content sites or when applying for a particular role in a firm which requires candidates to be of a certain age.

Sample Age Verification Form

Name: ____________________________

Email Address: _____________________

Shipping Address: (must match driver’s license)

________________________________

________________________________

________________________________

Under penalty of perjury, I do hereby swear that I am of legal age (this website requires that all customers be at least 21 years old) to purchase cigarettes and other tobacco products. By completing and submitting this form, I understand that I must comply with the law to be able to order and subsequently receive cigarettes and other tobacco products. Please print and sign this form. Please also attach a copy of your valid driver’s license or non-driver ID. You may either fax this form, or mail it along with your payment (check or money order) to:

Black Bear Smoke Shop

P.O. Box 66

Irving, NY 14081

Customer Signature _________________________________

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