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Credit Card Authorization
You may cancel this authorization at any time by contacting us. This authorization will remain in effect until cancelled.
Business Name
*
Card Type
*
Mastercard
Visa
American Express
Cardholder Name (as shown on card)
*
Card Number
*
Expiration Date
*
Billing Zip Code
*
By typing my name in the field below and clicking submit, I authorize 9 Bar Tech Co to charge my credit card above for agreed upon purchase. I understand that my information will be saved to file for future transactions on my account.
Customer Signature
*
Date
*
MM
DD
YYYY
Thank you!
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