Visa Corporate Credit Card

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Visa Corporate Credit Card Powered By Docstoc
					                  WANTECH INTERNATIONAL CORP.
                 30873 San Antonio St. Hayward, CA 94544
                 Tel: (510)489-4892 Fax: (510)489-4893
                         Please fill out this form, and send or fax to 510-489-4893

                                        CREDIT CARD AUTHORIZATION
1. For your convenience, we will use this authorization to charge your credit card account for your advance orders
   for PREPAID only, and any additional amounts incurred including furture orders.

2. Please supply the front and back copy of your credit card with completed authorization form for us to process your order.

3 All other term payment will have 3% credit card service charges added to your payment if you choose to pay
  by credit card after the payment due date.

4. The undersigned has read this Credit Card Authorization and agrees to be bound by the statements, terms
   and conditions herein.

       Company name:

        Street address:

                     City:                                            State:                Zip code:

                  Phone:                                                 Fax:

                Contact:                                                 Title:

          Credit card:           VISA    or      MASTERCARD         or      AMEX      (1% service charge for AMEX)

         Type of Card:                    Personal                Corporate

      Account number: x                                                               Expiration Date: x

          V.# (3 DIGIT) x_________(ON THE BACK OF THE CARD, LAST 3 DIGITS)

   Cardholder's name: x

        Billing address: x

                     City: x                                          State: x              Zip code    x

             Signature x
Driver license number x                                             State         x

    Expiration date          x

Hpserver\form\ACCTG DEPT/Credit Card Forms\CREDIT CARD AUTH.xls                                             revised on 2/22/07

Description: Visa Corporate Credit Card document sample