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ONE TIME CREDIT CARD AUTHORIZATION FORM
Account type: Visa ○ MasterCard ○ Discover ○ AmEx ○
Full Name On Card: _____________________________________________________________________
Account Number:_______________________________________________________________________
Expiration Date: ________________________________________________________________________
CVV2 - 3 Digit Sec Code (On back of card): _________________________________________________
Card Billing Address: _____________________________________________________________________
City, State & Zip code: ____________________________________________________________________
Phone Number:__________________________________________________________________________
Email Address: __________________________________________________________________________
I authorize Abracadabra Printing, Inc. to charge my credit card as indicated above for payment of goods and services, for the amount specified only, and this authorization is valid for one time use only.
I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; as long as the transaction corresponds to the terms outlined above.
Authorized Signature:___________________________________________________________
Date:__________________________________________________________________________
Updated 7/2017 Credit Card Authorization
Sign and complete this form to authorize Abracadabra Printing, Inc. to make a one-time debit to your credit card listed below.
By signing this form you give us permission to debit your account for the amount indicated on or after the indicated date. This is permission for a single transaction only and does not provide authorization for any additional unrelated debits or credits to your account.
_______________________________________________________________________________________ PLEASE COMPLETE THE INFORMATION BELOW
I_____________________________Authorize Abracadabra Printing, Inc., to charge my credit card account
indicated below for $_____________ on or after _______________
This payment is for Invoice Number:________________________
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