Transcription of CREDIT CARD AUTHORIZATION FORM - Tanzania …
1 CREDIT card AUTHORIZATION form . CREDIT card Information: All CREDIT cards accepted, except American Express. When you provide a debit or CREDIT card you authorize us to debit $ processing fee from your account for each transaction. Name: Billing address: City: State: Zip Code: I authorize the Embassy of Tanzania to charge the sum of : US$. CREDIT card type: Visa MC Di Other CREDIT card number: Expiration date: month year Security code: Cardholder Signature: Date: / /.
