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Credit Card Authorization Form

    Enter your full name

    Enter you contact number

    Enter the card's billing address eg: 123 Test Dr #1

    Enter in the City, State, and Zip code

    Select authorization type(s)

    Select the Card type

    Enter in the Credit Card Number

    Enter in the expiration date 01/2025

    Enter in the secuirty code, CVV

    Enter in your invoice list to apply payments toward, comments or addtional instructions