CHB License 9990
FMC License 3408
A tlanta Customs Brokers
& International Freight Forwarders, Inc.
650 Atlanta South Parkway – Suite 250 – Atlanta, GA 30349
Phone (404) 762-0953
Fax (404) 763-9628
CREDIT CARD AUTHORIZATION FORM
Name of Cardholder: _____________________________________________________
Credit Card No: _________________________________________________________
Expiration: ________ CVV2 Code:______ (on the back side of the credit card)
Billing Address: ___________ State:________ Zip:_________
Signature of Cardholder: _________________________________________________
Keep in File*: Yes_____ No_____
By checking yes you authorize Atlanta Customs Brokers to process your credit card automatically every time you have an invoice with our company.
The following service charge of 4% of the invoice will be charged
The following letter authorizes Atlanta Customs Brokers to charge my credit card for the amount of ________, which includes 4% of my invoice.
Import Air Fax (404) 763-9628 * Import Ocean Fax (404) 762-6817
Export Fax (404) 763-9630
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