I hereby certify that the above statements are true and correct to the best of my knowledge. I understand that the submission of false information may result in serious charges and that I am fully obligated in legal actions brought against me by Elim Jewelry Corp. I authorize Elim Jewelry, Corp. to process any and all charges outlined in existing agreement. I agree that this authorization shall continue in effect until revoked by me in writing but my obligation to pay is subject to the terms of the Agreement.