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Recurring Credit Card Authorization

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Recurring Credit Card Authorization Powered By Docstoc
					                     Credit Card Authorization for G.O. Auction
                                   11-46-214/264
                                  Online Auction
                                      2/24/11

                      Please type or clearly print information in form below.


Bidder’s User Name
Email Address
Name as it appears on credit card
Billing Address of credit card

City / State / Zip
Phone Number
Fax Number
Credit Card Type (check one)          □ MC        □ Visa       □ AMEX           □ Discover
Credit Card Number
Expiration Date (MM/YY)
Card Verification Code
Amount of Charge                      $2500.00

Signature:
Date:


Signature above authorizes URS to charge the required deposit amount indicated to
my credit card. This places a “hold” of the required deposit amount of $2500 on my
credit card. I understand that if I am a successful bidder, this amount will be charged
to my credit card as the initial deposit with any remaining monies owed also charged
to this credit card. I further acknowledge that if I am not a successful bidder, the
funds authorization will be voided by URS; however, a funds hold in the deposit
amount may be placed on my account by my banking institution lasting up to 30 days.


         Send completed authorization form, along with Bid Deposit Form, to Lydia Quental
                                        Fax: 703-330-4162
                                  Email: lquental@egginc.com



 THE BID DEPOSIT FORM MUST ACCOMPANY THIS CREDIT CARD AUTHORIZATION IN ORDER TO
PROCESS YOUR AUCTION REGISTRATION. FAILURE TO PROVIDE BOTH FORMS MAY RESULT IN A
DELAY IN PROCESSING YOUR REGISTRATION OR PREVENT YOU FROM BIDDING IN THE AUCTION.

				
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