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CREDIT CARD AUTHORIZATION FORM 2009

 
Link to Adobe Acrobat Format

I DO HEREBY AUTHORIZE
S.T.O. AUTO PARTS, INC. TO PROCESS MY CREDIT CARD FOR THE FOLLOWING AMOUNTS:

$   FOR PARTS ORDER

$  SHIPPING FEES (NON-REFUNDABLE) INITIALS

I WILL BE PAYING WITH:
CREDIT CARD TYPE (MASTERCARD, VISA, DISCOVER, AMEX)

CREDIT CARD #
3-DIGIT SECURITY CODE #

EXP. DATE:

NAME ON CREDIT CARD

COMPANY NAME ON CREDIT CARD

BILLING ADDRESS FOR CARD:

CITY:    STATE:   ZIP:

CONTACT PHONE NUMBERS:

HOME

WORK:

CELL:

VEHICLE INFO:  YEAR          MAKE:

MODEL:   2DR, 4DR, S/W, FWD, RWD, 2WD, 4WD, AWD

VIN #
EXTENDED WARRANTIES AVAILABLE: 60 DAYS, 90 DAYS, 1YR, 2YR, 3YR, ASK FOR QUOTE?

SIGNATURE x   DATE:
Billing and shipping address must match credit card used for purchase, Pennsylvania residents must pay applicable sale tax (7%). Returned parts are subject to a restocking fee of 25%.  Thank you!
Retail customers must attach a copy of a US / State photo ID for proof of identity. No exceptions!