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    Credit Card Authorization Form Sra. LIDIA S. 2023-FIRMA PDF

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    Ana Velasqz
    This document is a credit card authorization form that must be fully completed, signed by the authorized credit card user, and include a clear copy of both sides of the credit card as well as a passport and driver's license showing signature and picture in order to authorize Health to Travel & Top Vacations to charge the provided credit card number for $1978 USD. The form requests the credit card type, number, expiration date, CVV code, card holder's address, and signature of the authorized card holder certifying the statements made in the agreement.

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    Download as PDF, TXT or read online from Scribd

    Credit Card Authorization Form Sra. LIDIA S. 2023-FIRMA PDF

    Uploaded by

    Ana Velasqz
    3K views1 page
    This document is a credit card authorization form that must be fully completed, signed by the authorized credit card user, and include a clear copy of both sides of the credit card as well as a passport and driver's license showing signature and picture in order to authorize Health to Travel & Top Vacations to charge the provided credit card number for $1978 USD. The form requests the credit card type, number, expiration date, CVV code, card holder's address, and signature of the authorized card holder certifying the statements made in the agreement.

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    Credit Card Authorization Form Sra. LIDIA S. 2023-FIRMA.pdf

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    This document is a credit card authorization form that must be fully completed, signed by the authorized credit card user, and include a clear copy of both sides of the credit card as well as a passport and driver's license showing signature and picture in order to authorize Health to Travel & Top Vacations to charge the provided credit card number for $1978 USD. The form requests the credit card type, number, expiration date, CVV code, card holder's address, and signature of the authorized card holder certifying the statements made in the agreement.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    3K views1 page

    Credit Card Authorization Form Sra. LIDIA S. 2023-FIRMA PDF

    Uploaded by

    Ana Velasqz
    This document is a credit card authorization form that must be fully completed, signed by the authorized credit card user, and include a clear copy of both sides of the credit card as well as a passport and driver's license showing signature and picture in order to authorize Health to Travel & Top Vacations to charge the provided credit card number for $1978 USD. The form requests the credit card type, number, expiration date, CVV code, card holder's address, and signature of the authorized card holder certifying the statements made in the agreement.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Credit Card Authorization Form

    PLEASE READ THIS BEFORE YOU CONTINUE: FORM MUST BE COMPLETED IN FULL, SIGNED BY
    AN AUTHORIZED USER OF THE CREDIT CARD, ALONG WITH A CLEAR COPY OF THE CREDIT CARD BOTH SIDE AND
    AUTHORIZED USER PASSPORT AND DRIVER`S LICENSE SHOWING SIGNATURE AND PICTURE.

    -------------------------------------------LIDIA SALAZAR ------------------------------------------------BY EXECUTING THIS (NAME AS IT


    APPEARS ON CREDIT CARD)
    AGREEMENT UNCODITIONALLY AUTHORIZES HEALTH TO TRAVEL & TOP VACATIONS TO CHARGE THE FOLLOWING
    CREDIT CARD:

    CREDIT CARD TYPE: (CIRCLE ONE) Aamerican express

    CREDIT CARD NUMBER: -------377481312170076--------------------- EXPIRATION DATE: -------03-24----CW 2 CODE: -----969------------

    (EXAMPLE BELOW) FOR THE AMOUNT OF: $1978 USD------

    CARD HOLDER`S ADRESS:

    STREET: ----1875w44pl apartment 311a ---CITY: ------HIALEAH--------------STATE: ------------FLORIDA-------- ZIP CODE: ------33012---------

    ---- PROVINCE: ---------------------------------------------COUNTRY: ---------------------------------------------------------------------------------

    ---------------------------------------------- ------------- ------- ----------------------------------- CARD HOLDER AUTHORIZED


    SIGNATURE DATE

    I CERTIFY THAT THE ABOVE STATEMENTS AND INFORMATION MADE IN THE AGREEMENT ARE TRUE AND CORRECT TO THE BEST
    OF MY AKNOWLEDGE. I ALSO CERTIFY THAT I AM AUTHORIZED IN EFFECT CHARGES TO THE ABOVE CREDIT CARD NUMBER.

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