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Credit Card Authorization

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					Print Maniac.com PO Box 4473 Odessa, TX 79760 (800) 553-1361 FAX: (800) 553-1361

CREDIT CARD AUTHORIZATIO
JOB TITLE: ___________________ INVOICE #: ___________________ AMOUNT OF SALE: ________

I,
PRI T AME PLEASE

, authorize
PERSO OR ORGA IZATIO

to use my credit card (
CREDIT CARD UMBER

). Type of card:
VISA, MASTER CARD, AMERICA EXPRESS

Name on card: Billing Address for card: City: Expiration Date: /

State:

Zip:

CVV2# (Last 3 Digits on back of card) ________

Authorized signature

Date

Printed ame /Title

Phone umber

-By signing above, I have indicated that I have carefully reviewed the proof sent to me (either in paper or email form), and that I am giving approval for the job to be printed. If I do not require a proof, by signing above, I am stating that I am responsible for the content of my files, and that errors in them are my sole responsibility. I understand that any errors on the proof that I did not bring to the attention of PrintManiac.com are my sole responsibility, and PrintManiac.com is not responsible for reprinting, repressing, refunding, shipping charges, or in any other way responsible for damages that I may incur from said error. I am also indicating that I am an authorized agent/signer for this job.


				
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