CREDIT CARD AUTOMATIC AUTHORIZATION FORM (ON FILE)

5855 Obispo Beach, CA 90805 Tel: 1-877-SUN-LANDFax: 1-562-808-8127 (A/R) CREDIT card AUTOMATIC AUTHORIZATION form (ON FILE) COMPANY NAME _____COMPANY ID _____PHONE NUMBER _____FAX NUMBER _____I hereby authorize Sunland Shutter to automatically charge 50% or more of deposit / balance amount for all of my orders on my CREDIT card as listed below that will be kept on file. I will be liable to pay any return fees of $25 or CREDIT card IS TO BE USED FOR DEPOSIT ONLY BALANCE ONLY BOTH DEPOSIT AND BALANCES(PLEASE MARK ONLY ONE OF THE ABOVE)NAME AS IT APPEARS ON card (PRINT) _____CREDIT card NUMBER _____EXPIRATION DATE _____5 DIGIT BILLING ZIP CODE _____CARD HOLDER S DRIVER LICENSE NO. _____CREDIT card TYPE MASTER 3 DIGIT VERIFICATION CODE _____ VISA 3 DIGIT VERIFICATION CODE _____ AMEX 4 DIGIT VERIFICATION CODE _____ E-MAIL ADDRESS _____This will remain in force unless you receive written change stating otherwiseAUTHORIZED CARDHOLDER SIGNATURE _____DATE _____5855 Obispo Beach, CA 90805 Tel: 1-877-SUN-LANDFax: 1-562-808-8127 (A/R) CREDIT card AUTHORIZATION form (ONE TIME)COMPANY NAME _____COMPANY ID _____PHONE NUMBER _____FAX NUMBER _____NAME AS IT APPEARS ON card (PRINT) _____CREDIT card NUMBER _____CREDIT card TYPE MASTER 3 DIGIT VERIFICATION CODE _____ VISA 3 DIG

5855 obispo ave. long beach, ca 90805 tel: 1-877-sun-land fax: 1-562-808-8127 (a/r) credit card automatic authorization form (on file) company name _____ company id _____

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  Form, Land, Direct, Life, Automatic, Card, Authorization, Of lien, Credit card automatic authorization form, Sun land

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