Credit Card - Sancar Wallcoverings

Sancar

Wallcovering and Decorating, LLC

3517 Quentin Road
Brooklyn, NY 11234-4230
TEL: 718.998.6600

credit card authorization form

1, (print name), holder/owner of the following credit card, hereby authorize Sancar Wallcoverings & Decorating, LLC to charge my credit card for the amount indicated below

Invoice #

Amount $

Billing information (address where monthly card statement is sent):

Credit Card information:

Name (as it appears on card):

Visa

MasterCard images

Credit Card Number:

Exp. Date: /

By signing this agreement, I acknowledge the charges described above and assume full responsibility for said charges and agree to honor and abide by the purchase, payment, shipping and return terms of Sancar Wallcoverings & Decorating, LLC.

Authorized Signature: Date:

Home Page

Solverwp- WordPress Theme and Plugin