A to Z Sound Services, Inc. Credit Card Authorization Form

CREDIT CARD AUTHORIZATION

I, _______________________ Herby authorize A to Z Sound Services, Inc. to initiate charges to the credit card listed below, and authorize the credit card institution to accept the amount of such charges to the credit card listed below to pay off the following invoices listed below:

Invoice #		$
Invoice #		$
Invoice #		$
Invoice #		$
Invoice #		$
	Total	$

Credit Card #

Exp. Date

CVC # If assigned___________________

Credit Card Type:____ MasterCard____ Visa____ AmericanExpress ___ Discover

CreditCard Issued To: _______________________________________________
(Print Name exactly as on Credit Card)

Credit Card Billing Address: ___________________________________________
(Name on Statement)

___________________________________________
(Address on Statement)

___________________________________________
(City, State, and Zip Code on Statement)

___________________________________________
Signature of Authorized Used Date

Please complete the above Information and Fax back to us at: (909) 585-5911

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