Canada ComputerBooks Inc.
One-Time Credit Card Authorization
Instructions
| I, _______________________, hereby authorize ________________________ to use my ________ card # _________________________ expiry date _______ for the purchase of merchandise from Canada Computer Books Inc., as detailed in Order # ____. For verification purposes, I confirm that my name, as it appears on my credit card, is ___________________, and that the billing address for this account is ___________________________________________. Cardholder Signature: _____________________________ Date: ____________________ |