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Credit Card Authorization

Subject of Request
Invoice No.
From (YOUR EXACT NAME AS IT APPEARS ON YOUR CREDIT CARD)
Company Name
Credit Card Billing Address
City
State
Zip Code
Home Phone
Work Phone
Your Email Address
BY THIS MEMO, I AUTHORIZE PRIVATE DETECTIVE SERVICES, dba PrivateDetectiveServicesNow.com, TO BE PAID FOR THE TRANSACTION OF THE ABOVE-REFERENCED COMPANY IN THE AMOUNT OF
BY USING THE CREDIT CARD LISTED BELOW:
MastercardVisaAmerican ExpressDiscover
Credit Card Number
Expiration Date
3- OR 4- Digit Security Code
I understand the charge for the above service is non-refundable, non-revocable and non-contestable. I waive my right of re fund and / or to dispute the charge.
Authorized Signature of Credit Card Holder
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