Gradys Radio & Satellite "Credit Card Chargeback Agreement"

Please print, read, and fill in this page and fax it back to us at 1-207-284-8461 so we may process your order. Orders without this agreement will not be processed.

I hereby certify that I am:

1. The authorized user of the credit card listed below.
2. That I am not nor any member of my family have ever been a Dish Network customer and the system being purchased is for use in and by my family and is for residential use only. If I purchase a system for a friend or relative and submit the credit card listed below, I am accepting all conditions listed and outlined in this Purchase/Sales Charge Back Agreement for Gradys Radio & Satellite prior to the purchase. I agree to pay all chargeback monies and/or collection fees.
3. I agree to activate the satellite system and/or receiver within 14 days of receipt. Use of any Install and or Gift Certificates or any other Dish Network coupon is not allowed and will result in a $100.00 charge to your credit card. This is an agreement between Gradys Radio & Satellite and the card holder and has nothing to do with Dish Network.
4. I agree that I must maintain required programming for a minimum of 240 days from original date of activation (Required Programming must include Americas Top50, Top100, or Top150). No interruption of subscription can occur during this period. This includes billing, payment, or any other problems. It is the card holders responsibility to settle all disputes with Dish Network and the card holder holds Gradys Radio & Satellite harmless.
5. I have read and agree fully with the terms listed in the "Credit Card Charge Back Agreement.
6. I agree to have a valid credit card on file at Gradys Radio & Satellite during the full chargeback period. If in the event I fail to meet these requirements I hereby authorize Gradys Radio & Satellite to charge my credit card listed below as follows:
A. Complete system purchase: Chargeback....$250.00 ( a system purchase must be activated as a main system and can not be used to replace, add, or update an existing system).
B. Additional Receiver: Chargeback....$50.00 ( An additional receiver must be activated as an additional receiver with a fee of 4.99 per month and can not be used to replace an existing or defective receiver).
C. I acknowledge and agree that Gradys Radio & Satellite is not extending credit to me and the chargeback fee is not a credit or service charge but is part of the original selling price and the stated amount sold to me as a discount if I agreed to all of the above conditions. I agree to let Gradys Radio & Satellite reclaim the monies as stated above if I do not maintain the required programming with Dish Network ( A Pay Satellite TV Programming Provider) for the 240 days without any interruption.

City____________________________________ State______________________ Zip Code________
Home Telephone____________________________ Daytime Phone___________________________
E-Mail Address _____________________________________________________________________
Credit Card Type____ Credit Card Number __________-________-_______-_______Exp. _____/____
Signature______________________________________________ Date________________________
(Address verification will be done before order ships)
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