Credit card authorization letter

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					                      CREDIT CARD AUTHORIZATION


TYPE OF CREDIT CARD:


CREDIT CARD NUMBER:


EXPIRATION DATE:


SECURITY CODE: (the last four or three digit number in the back of your credit card)


CARD HOLDER'S NAME:


TOTAL AMOUNT TO CHARGE:


BILLING ADDRESS:




MAILING ADDRESS (IF DIFFERENT FROM ABOVE)




TELEPHONE NUMBER:


CARDHOLDER SIGNATURE:


DATE:

				
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posted:10/4/2012
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