Credit Card Auth Form| Credit Card Authorization |
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DiscountBeautyDepot LLC Credit Card Authorization Form Atlanta, Ga 30364 Fax: (800) 456-9236 Print, and complete and sign the form below. Fax it with these other required documents. All request information and documentation is required or we cannot process the order. If not received within 2 days the order will be cancelled. 1. A copy of the cardholder’s credit card ( front only) you can white out the all the digits except the last digits 2. A copy of the cardholder’s driver’s license or other type of photo I.D. (you can white out your driver license #) -OR- 3. We can call your Credit card/Bank to verify the charge amount. You will have to call your cc/bank to approve the amount and then we will call your bank to verify the transaction amount. Cardholder’s Name: _________________________________________________ (please print) Billing Address: _________________________________________________________________ City: __________________________________________________________________________ State________________________________ Zip__________________________________ Telephone: __________________________________ (landline only – no cellular) Email :_____________________________________( must be your real ISP email or paid website email) Order Number: _____________________________ Date of order: _____________________________ Total Amount of Purchased to be charged to my credit card: $_____________________________ Type of card: __________________ (Visa-Master-Discover-American Express) Card number used to place this order: _____________________________________________________ Bank Phone Number on the back of the card: ______________________________________________ I understand these charges will appear on my credit card statement under the name of DiscountBeautyDepot.com and I accept full financial responsibility for payment of this order. Further I also enclosed a copy of the front of my credit card as well as a copy of my legal driver’s license or other photo I.D. for identity verification purpose. Signature of Cardholder: ____________________________________________________________ Date Signed: _____________________________ Email: *ALL* required documents to: This e-mail address is being protected from spambots. You need JavaScript enabled to view it Fax: *ALL* required documents to: (404)768-3929 |
