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                                                       R I S T O R A N T E

             i Ricchi

GIFT CARD PURCHASE FORM

Please complete the form below and fax to (202) 872-1220.

Purchaser Information

Full Name: _____________________________________________

Telephone: _____________________________________________

Address: _______________________________________________

             _______________________________________________

Payment Method: r VISA r Mastercard r American Express

Card Number: _________________________   Expires: __________

Gift Card Amount(s): ______________________________________

Delivery Information

Full Name: ______________________________________________

Address: ________________________________________________

             ________________________________________________

Notes: _________________________________________________

We will contact you by phone to confirm

your purchased gift card has been sent.

I hereby authorize I Ricchi to charge my credit card as shown above for said purchase amount.

_______________________________________________ _________________

                 Cardholder Signature                                                           Date