CREDIT CARD AUTHORIZATION FORM |
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LETTER OF AUTHORIZATION TO CHARGE CREDIT CARD |
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I authorize MooreMarine
Services & Boat Rentals to charge to the following
described credit card the NONE REFUNDABLE DEPOSIT or remainder due for Rental
Services จ, Transportation
จ, Purchase of products จ, in the
amount of: US ญญญญญญญญญญ__________ (20%) For:___________________________________
_Boat. On Date:___________________ |
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Card Holder's Name On
Card: ______________________________________________ |
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Cardholder's Contact
Information, including billing address: |
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Street
Address: ___________________________________________________________ |
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Suite/Apt.
No.: ___________________________________________________________ |
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City:_____________________________________________________________________ |
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State/Province/District:
_____________________________________________________ |
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Country:
_________________________________ Zip Code:_____________________ |
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Billing
Address Phone: ____________________ Alternate Phone:
________________ |
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Billing
Address Fax: _______________________ Alternate Fax: __________________ |
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Email
Address: __________ญญญญญญญญ___________________@_____________________________ |
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Signature:_________________________________________________________________ |
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Printed
Name: ________________________________ Date:______________________ |
Please Highlight and Print This Form. Your completion of this authorization form helps us to
protect you, our valued customers, from credit card fraud. All information entered
on this form will be kept strictly confidential.