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Letter of Authorization to Charge Credit Card

I authorize Collector's Paradise, Inc. to perpetually charge to the following described credit card the amount equal to the value of product I have agreed to purchase, until I notify them to stop. The amount I shall be charged, whenever appropriate, as agreed, shall be equal to the total retail value of the product I agreed to purchase, minus any discounts given to me at the time, plus any applicable sales taxes and/or shipping amounts.

Name *

First

Middle

Last

Phone *

Email *

Name on the credit card *

First

Last

Credit Card Number *

Credit Card Type: *

Expiration (MONTH) *

Expiration (YEAR) *

Security Code: *

Billing Address *

Address Line 1

Address Line 2

City

State

Zip Code

By typing my name below, I agree that I have digitally signed this form and agree to all the terms above. *

First

Middle

Last

Today's Date: *

Pick your store: *

Phone

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Letter of Authorization to Charge Credit Card