Credit Card Authorization Form Warmup
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CREDIT CARD AUTHORIZATION FORM The world’s best-selling electric floor heating brand ™ Please consider returning the Credit Application Form attached in order to be set-up on terms and facilitate prompt shipment of your orders. We have included a copy of our Business Terms and Conditions. We are very appreciative of your business. Call or email us with any questions. Company Name: ____________________________________________________________________ Card Holder Name: __________________________________________________________________ Order/Invoice number: ______________________________________________________________ Billing Address Street Address: __________________________________________________________ City: __________________________________________________________________ State/Province: ___________________________________ Zip Code/Postal Code: ______________________________ Credit Card Type (circle one): American Express (US only) VISA Master Card Discover Credit Card Number:_________________________________________________________________ Exp Date: _______ /________ Security Value/Exp (3 digit code on back for VISA & Master Card, 4 digit code on front of AMEX):__________ Card Holder Signature:________________________ Date: ___________________ month day year I, the above named card holder and authorized signatory, agree to have my credit card charged by Warmup Inc in the amount listed above. I furthermore agree to adhere to the terms and conditions set forth in my card holder agreement. By signing this document I understand that the amount charged by Warmup Inc for merchandise, services provided, fees and/or any other charges are wholly covered under the terms and conditions set forth by the applicable Warmup Inc documents relating to said merchandise, services provided, fees and/or any other charges, this includes, but is not limited to cancellations, returns, and warranties. Returns and cancelations may require a restocking fee as determined by Warmup Inc. WARMUP INC. Tel.: 1-888-927-6333 Fax: 1-888-927-4721 USA: www.warmup.com | Canada: www.warmup.ca USA: us@warmup.com | Canada: ca@warmup.com The world’s best-selling electric floor heating brand ™
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