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Verification Form
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MEMBER INFORMATION

Legal Name
FIRST Kasey LAST
Gilbert

Billing Address
STREET 15030 15th Street CITY
Bonner Springs
STATE AZ ZIP COUNTRY
66012 United States

Email Address

lawrencekpromotions@gmail.com

MV Username

1211OnlyFans

By signing this form, I agree:

1. That I consent to disclosing my personal information for the purposes of verifying my identity as a good and trustworthy
customer of ManyVids.com.
2. That the personal information provided above is accurate and free of error.
3. That the personal information provided will be safeguarded according to the ManyVids privacy policy available at:
https://www.manyvids.com/Information/
4. That I authorize ManyVids.com, including its authorized billing processors, to process payments (including credit card
transactions) corresponding to any online orders placed through my ManyVids.com member account.

SIGNATURE DATE
05/10/20