Crypto Payment Order Form

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Please verify all addresses are accurate. Some Wallets may have a Memo Key or ID additionally to the wallet address, such as XRP, when sent to an exchange. Crypto Prices are rounded up to the nearest dollar, If shipping outside continental USA add $12 to the total)

Due to the volatility of crypto please do your best to calculate the USD amount equivalent to your order. You can verify the quantity of Token you need to send using this tool: https://coinmarketcap.com/converter/

BITCOIN (BTC): bc1qgzf4ycumu3q44lkea8ulr83y3yrm53ghr3nra3

ETH/BNB/AVAX/POLYGON: 0x0d56e965cD7be72350b5C17C283a6db2B5Be41d3

XRP: rwbFmoWetta9foajqJrKjYRtEAosHBbUcw

XLM: GDLQUMSYRE56LLVUN7XHALHJZ7PLK5ZMB6E4RC64O56XDHWCEXSIDYOT

XDC: xdc58085917B4052Dc6E8efCF68E2efB56db8AA04B3

SOLANA: 6C78SYZ4FmzsBEM1ESZpJrdFYmKc8PDudGw8AMV5MLFd

HBAR: 0.0.1269972

ALGO: XGDA7M6CI7ZM2GM6TZZI6LL6OGTOUJ3POVM6O2F7OTZ72TLIEQKHUP5SGM

CARDANO: addr1qystkwau5jyxd8fnzknjfc5kxv9hfaeut4m8fmf9d4qcd2wfeqzunfuzdvas294dmd6d265aep7u87eg8ypwx4flq84qvymykx

CASPER: 02039c8b15381c9161bf4f952f96bbf04f1959f467dbe78af6da21c60a66c7f848bb

Email *

Record my email address with my response

What Product or Service are you paying for? *

Freedomanna Products (Please Fill Out Shipping information and order details below)

Crypto Services

Other:

Name *

Shipping Address

Phone Number (Order Confirmations & text updates)

ORMUS Amount/Quantity

individual $45 ($57 international)

4 Pack $134 ($146 International)

10 Pack Bulk powder $278 ($290 International)

10 Pack Individuals $334 ($346 International)

50 Pack Individuals $1112 (Free International Shipping)

100 Pack Individuals $2,334 (Free International Shipping)

500 Gram Bulk Powder $888 (Free International Shipping)

1 Kilogram Bulk Powder $2000 (Free International Shipping)

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PROOF OF PURCHASE: Please post your wallet address, the relevant transaction hash, and which coin you sent for the order for smoother customer service.

A copy of your responses will be emailed to .

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