Credit_Card_Authorization_Form by liuqingyan


									                       Credit Card Payment Authorization
       Please fill out this form with BLOCK letter and return it back to the secretariat via email or fax.
                                                  Thank you!

                                      IDMC'11 Secretariat c/o Elite PCO
          Tel: 886-2-8502-7087 Ext. 25 | Fax: 886-2-8502-7025 | Email

 The cardholder hereby authorizes the IDMC'11 to charge the undersigned's credit card, of
             which details are given below, for the conference registration.

           Registration No.

           Full Name:
           (Underline the Family Name)

           Amount Paid:                   NTD (Money) (≒ USD (Money))

           Credit Card:                        VISA       Master Card         JCB

           Card Issuing Bank:

           Card Number:

           Expiration Date:

           Name of Card Holder:

           The last three digit on
           the signature

           Authorization Signature:

           Authorized Date:

           Authorization Code:

Credit card organization in mail order business involve the funds relation of advancing the amount
of the money only. Did not get involved the entity relation of the business such as consignation of
the defect of the merchandise. After the usage of the cardholder to carry on the bargain of mailing
order of the business those who depends on the consumer protection method Article 19 rule to
mail order the business to annual contract should first turn to the mail order business to solve, as
can’t solve, get the request to deliver the card organization that trades to handle the procedure to
carry out with the account payment doubt.

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