Credit card authorization form



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Date10.08.2017
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CHB License 9990

FMC License 3408

IATA 01-1-9574


Atlanta 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

Invoice ______________


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.

**PLEASE NOTICE**

The following service charge of 4% of the invoice will be charged

**PLEASE NOTICE**
The following letter authorizes Atlanta Customs Brokers to charge my credit card for the amount of ________, which includes 4% of my invoice.

E-mail: hope@atlantacustomsbrokers.com

Import Air Fax (404) 763-9628 * Import Ocean Fax (404) 762-6817



Export Fax (404) 763-9630


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