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Credit Card Authorization Form |
Credit Card Authorization Form
| To have your credit card charged for See IT Through (SIT) services, we MUST have the following signed statement on file. Please submit this form to SIT via fax or postal mail using the fax # or address listed below. | |
| Name as it appears on the Credit Card: | ______________________________ |
| Address where CC statement is received: | ______________________________ |
| Address line 2: | ______________________________ |
| Address line 3: | ______________________________ |
| Work Phone: | ______________________________ |
| Alt. Phone: | ______________________________ |
| Fax: | ______________________________ |
| E-mail: | ______________________________ |
| Account Name: | ______________________________ |
| Credit Card Type (Circle one): | Visa Master Card Discover American Express |
| Credit Card Number: | ___________-___________-___________-__________ |
| Credit Card Exp.: | ___________/___________ |
Credit Card Security Code
(3 or 4 digit code in upper
right corner of signature panel)*:___________ *If your Credit Card has no Security Code, please put ‘None’ |
|
| I authorize See It Through to charge my Visa / MasterCard / Delta / American Express account for those charges for See IT Through service that I may accrue from month to month or any past due balances in order to bring the account to current status. This authorization is valid until revoked in writing. | |
| _________________________ | ___________________________ |
_____________ |
| Name (signed) | Name (printed) |
Date |
See It Through |
E-mail: sales@seeitout.com |
PO Box KL602 Kings Langley NSW 2147 Australia _________________________ |
Outside Australia |
Ph: (61) 2-9624-7220 |
Fax: (61) 2-9624-7226 |
From Australia |
Ph: 02-9624-7220 |
Fax: 02-9624-7226 |