CREDIT CARD CHARGE AUTHORIZATION by alicejenny

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									CREDIT CARD CHARGE AUTHORIZATION AGREEMENT

I, ___________________________________________, the holder of (check one, please):

              VISA ___ MasterCard ___ American Express ___ Discover ___

Card Number: _________________________________________________ and expiration
date

____/____ hereby authorize PrepaidOnline.com to charge the amount of $__________

representing a payment for _________________________________________________.

I have read this entire agreement and understand that I will be held fully responsible for its
terms and charges and I agree that all sales are final and that there are no refunds
whatsoever.

Cardholder: _______________________________________________________________

CVV # (on back of card): ____________

Signature: ________________________________________________________________

Company: ________________________________________________________________

Address: _________________________________________________________________

City, State, Zip: ____________________________________________________________

Telephone: (_______) ______________________________________________________


Date: _____________/__________________/_______________


Fax this completed form to the PrepaidOnline.com Accounting Direct Fax:
1+404-671-9475 or email to support@prepaidonline.com

								
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