To be on the safe side, I always use US based VPN and the gift card method. I have also bought from the UK store for books that were not available in the US or cheaper in the UK. I know other people are buying with no problems without such precautions, but who knows when they will suddenly tighten their policies?
On the other hand, since the Big 5 started their price fixing scheme last year I have bought relatively few books from Amazon. There is plenty of other stuff to read.
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