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: _______________________@________________________._________


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: _____/______/__________