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 firstname.lastname@example.org 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: (month/year) Name of Card Holder: The last three digit on the signature panel(needed) 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.
Pages to are hidden for
"Credit_Card_Authorization_Form"Please download to view full document