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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