USED COMPUTER SHOP - CREDIT CARD AUTHORIZATION - PLEASE PRINT AND FAX YOUR
PURCHASE ORDER TO 1-514-221-2383
Click
HERE for
shipping prices. |
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All Sections Below Must Be Complete In Order To Process Your Shipment
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Company Name: |
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Billing Address For Card: |
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Contact Name: |
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Phone Number: |
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Card
Type: _______________________________
Issuing
Bank: _______________________________
Name On
Card: _______________________________
Dollar
Amount: _______________________________
Account
Number: _______________________________
Expiration: _______________________________
Security # on back: _______________________________
Signature: _______________________________
Customer PO #: _______________________________
Date: _______________________________
*Please note that the buyer is responsible for all shipping
and custom costs.*
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