CREDIT CARD AUTHORIZATION FORM

 

 

 

 

CREDIT CARD AUTHORIZATION FORM

 

Please fill out this form COMPLETELY and LEGIBLY and return to us

by mail or fax as soon as possible or processing and shipping could be delayed.

 

I, ____________________________, authorize Jack Eubanks Auctions, LLC, to

     (Complete name as it appears on the credit card)

 

charge my VISA ______ or MasterCard ______ for the total amount of $______________.

 

Credit Card # ___________________________________ Expiration Date ____________

 

Credit Card Holder’s Address:

(The address where the credit card bill is received)

 

______________________________________________

 

______________________________________________

 

______________________________________________

 

______________________________________________

 

TEL: ______________________________

 

FAX: ______________________________

 

Signature: ______________________________________ Date:____________________

                                         (Signature of Credit Card Holder Required)

 

Thank You for Your Cooperation

NOTE: Forms not properly completed will not be executed.

 

 

Jack Eubanks AUCTIONS, LLC

P.O. Box 346  Brevard, NC 28712-0346

828.884.7889  Fax: 828.862.8310

Auctioneer: Jack C. Eubanks, NCAL #6337 - NCAFL #8410   Email: info@jackeubanks.com