LETTER
OF
AUTHORIZATION TO CHARGE CREDIT CARD
I, ____________________________, authorize Collector's Paradise to perpetually
charge
to the
I have agreed
card will be charged only if I fail to pick up my subscription for 3 or more consecutive weeks.
I
agree that if I notify the store to stop my subscription, I give them
permission to charge
me for the balance
of books in my hold box. The amount i shall be charged, whenever
appropriate, as agreed,
shall be equal the total retail
value
percentage given to me
at sign up, plus any applicable
Card
Holder's
Name on Card: ______________________________________________
Credit
Card
Type: ______ MasterCard
______ Visa ______
Discover ______ Amex
Credit
Card
Number: ____ ____
____ ____
Exp. Date: ___/____
Cardholder's
Contact
Information, including billing address:
Street
Address: ________________________________________
City: _______________________
Country: ______________________________
Zip Code: _______________________
Billing
Address
Phone: (___)_______-_______ Alternate Phone:
(___)______-_________
Email
Address: _______________________@________________________._________
Signature:
___________________________________
Printed Name: _____________________________ Date: _____/______/__________