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REPTILES
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Visa/MasterCard/American Express Credit Card Authorization Contract I (Cardholder) ___________________________________________________________________________ authorize REPTILES TO GO .COM to utilize the following credit card for present and future transactions made by myself. This includes allowing others (family, friends, partners, etc., ...) to sign any necessary receipt forms for such. Cardholder's name as it appears on credit card ________________________________________________________________________________________________________________________ Credit Card Billing/Shipping Address _________________________________________________________________________________________________________________________________ Alternate Shipping Address ________________________________________________________________________________________________________________________________________ Credit Card Number, Include 3 digit Verification Code from back of Visa or MasterCard OR 4 digit non-embossed Verification Code from front American Express card : ________________________________________________________________________________________________________________________________________________________________ Credit Card Expiration Date _________________________________________________________________________________________________________________________________________ Telephone Number(s) ____________________________________________________________________________________________________________________________________________ TERMS
Cardholder's Signature__________________________________________
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Post Office Box 313, Myakka City, FL 34251 USAi941 322 0241i941 322 0261 faxiinfo@reptilestogo.com © 1992-2011 David Barkasy |