| MASTER SHEARS | ||||
| 7578 Presidents Drive, Suite-A Orlando, FL 32809 USA | ||||
| Phone (407) 850-2119 * Toll Free (866) 850-2119 * Fax (407) 850-9075 | ||||
| E-mail: sales@mastershears.com Website: www.mastershears.com | ||||
| Account Set Up Information | ||||
| (Please attach a legible copy of your State Sales Tax ID) | ||||
| Customer Name: | Today's Date: | |||
| Business Name: | Shipping Address: | |||
| Address: | ||||
| Telephone # | Billing Address: | |||
| Cell Phone # | ||||
| Fax # | ||||
| E-mail: | ||||
| Website: | Tax ID # | State: | ||
| PRE-AUTHORIZATION FORM | ||||
| I authorize MASTER SHEARS to keep my signature on file to charge my VISA / DISCOVER / AMEX / MASTER CARD account for every time they ship merchandise to me. I have attached a legible photocopy of my Driving License or State ID with this form. I waive any defense against this authorization from the bank and MASTER SHEARS. | ||||
| Card Type | ||||
| Bank Name | Attach a copy of your Government Issued ID/ Driving License here. | |||
| Credit Card # | ||||
| Expiration Date: CVC# | ||||
| Card Holder Name | ||||
| Card Holder Complete Billing Address | ||||
| Card Holder Signature | ||||
| Date | ||||