CREDIT CARD AUTHORIZATION

 

I hereby authorize Special Effects Unlimited to charge $___________________to the below referenced credit card.

Name:                                                                                    Phone:

Company Name:

Address:

City

State

Zip

Credit Card #

     

Exp. Date                                                                  CV Code:

Visa___________Mastercard______________Amex______________Discover____________

   I promise to pay such amount as noted above subject to and in accordance with the agreement governing the use of such card.    

Signature:

   

1005 N. Lillian way, Los Angeles Ca. 90038

(323)466-3361  Fax  323-466-5712