LETTER OF AUTHORIZATION TO CHARGE CREDIT CARD

 

 

I, ____________________________, authorize Collector's Paradise to perpetually


charge to the following described credit card the amount equal to the value of the product


I have agreed to purchase in my subscription agreement, until I notify them to stop. The


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 of the product minus the discount


percentage given to me at sign up, plus any applicable sales taxes.

 

 

Card Holder's Name on Card: ______________________________________________

 

Credit Card Type: ______ MasterCard ______ Visa ______ Discover ______ Amex

 

Credit Card Number: ____  ____  ____  ____  Exp. Date: ___/____  Sec. Code: _______

 

 

Cardholder's Contact Information, including billing address:

 

Street Address: ________________________________________  Suite/Apt. No.: ____


City: _______________________  State/Province/District: _______________________

 

Country: ______________________________ Zip Code: _______________________

 

Billing Address Phone: (___)_______-_______ Alternate Phone: (___)______-_________

 

Email Address: [email protected]________________________._________

 


I AGREE to make sure my credit card information is current, and provide new expiration date


whenever my current card expires. 


 

Signature: ___________________________________

 

 

Printed Name: _____________________________   Date: _____/______/__________