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AUTHORIZATION FOR CREDIT CARD PROCESSING |
Please use our convenient Authorization Form to either Fax or Mail in your Order!
NOTE: In order for a Credit Card to be processed, ALL
information must be EXACTLY
as it appears
on your monthly Credit Card billing statement.
DIRECTIONS:
1.] Print out this page. [You may CLICK HERE to
automatically print this page.]
2.] Complete all sections, printing clearly.
3.] Submit your completed Authorization Form by
Faxing to:
1.570.828.8889
or
Mailing
to:
Witty1 Productions, Inc.™ | RR2 Box 1155 - 103 Johnny Bee Rd | Dingmans Ferry | PA | 18328
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Name: ____________________________________________________________
Company: _________________________________________________________
Address: __________________________________________________________
City: _____________________________________________________________
State: __________________ Zip: __________________
Phone: ___________________________________________________________
URL: ______________________________________________________________
Email: _____________________________________________________________
Company Description / Type: __________________________________________
Card Type - YOU MUST CIRCLE ONE:
American Express | Discover | MasterCard | Visa
Credit Card Number: _________________________________________________
Three Digit Number: (on back of credit card) _____________________________
Expiration Date: ____________________________________________________
Total Amount to be Billed: ____________________________________________
I have read and agree with the Policy Statement of
Witty 1 Productions, Inc.™,
as outlined
on their website: www.witty1.com.™ I hearby grant my permission
and authorization for my Credit Card to be billed in the amount set above for the following
professional services:
___________________________________________________________________
___________________________________________________________________
I hereby grant authorization to Witty 1 Productions, Inc.™,
to use all photos and materials
submitted by me for the above project. Said photos and materials are my personal property,
which shall be returned to me upon project completion.
Date: ___________________ Signature: _________________________________
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SECURE MERCHANT ACCOUNTS |
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Prior to placing your order, please read our:
Policy Statement. By placing your order, you are confirming review and approval.
Advertisers: Please review our Terms and Conditions Policy
prior to submitting Ad Requests. By placing your order, you are confirming review and
approval.
Thank you for your patronage! We look forward to working with you! |
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