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: _______________________@________________________._________

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: _____/______/__________