Payments | Inventions International Inc.

Credit Card Authorization
Card Holder Name*
Prefix First Middle Last Suffix
Email*
Enter Email Confirm Email
I, (Card Holder Name) hereby represent that I have the authority to execute this credit card authorization and agree that this Authorization will be immediately effective. I understand and consent to the use of my credit card without my signature on the slip, that an email, photocopy, or fax of this agreement will serve as an original, and this Credit Card Authorization cannot be revoked.*
- Yes
- No
Signature*
I, (Card Holder Name) hereby represent that I have the authority to execute this credit card authorization and agree that this Authorization will be effective on the date above. I understand and consent to the use of my credit card without my signature on the slip, that an email, photocopy, or fax of this agreement will serve as an original, and this Credit Card Authorization cannot be revoked.

Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Untitled
Product Name
Price: $0.00 Quantity:
Comments
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