Teacup And Toy Pets Credit Card Form # 3
Teacup and Toy Pets
10308 US HWY 8O Forney Texas 75126
www.TexasTeacups.com ww.TeacupAndToyPetsBoutique.com
( 972 ) 552-1989 / Fax ( 972 ) 552-9241 or 480-247-4749
MANUAL CREDIT CARD AUTHORIZATION Form # 3
PET SHIPPING, HEALTH CERTIFICATE, PET SUPPLIES, VET SERVICES, MISC
I am AUTHORIZING charges in the amount ON LINE ( 1. ) to be charged to my credit card for shipping, health certificate, pet supplies, vet services, and misc.
( 1 ) Enter Amount of Charges > $_________________________________________
( 2 ) Enter Print Name That Is On The Credit Card > _________________________________________________
Circle Credit Card to be used: ( Visa ) ( Master Card )
( 3 ) Enter Credit Card Number Here >______________________________________________________________
( 4 ) Enter Expiration Date Here >________________________________
( 5 ) Enter Security Code Here > ___________________________ ( CVV2 )
( 6 ) Authorization Code___________________________________________
( Will Be Provided by TeacupAndToyPets )
( 7 ) Enter Total Amount of Charge Here >___________________________________________
( 8 ) Enter Date of Charge Here >_____________________________________________
( 9 ) Signature of Card Holder Authorizing Charges > ______________________________________________
^ Sign Your Name Here ^