lecTRANSFER

lecTRANSFER DELIVERY AT ITS BEST CREDIT/DEBIT CARD AUTHORIZATION FORM I authorize K&K Transfer, Inc. and its representatives to charge goods and services requested by myself or an authorized signer of this account to my credit/debit account listed below: Card Type (Check One) Visa MasterCard Card Account Number: Expiration Date: V-Code (3 digit code on back of card) Quote/Invoice tt Amount to be Charged $ Client Name Name on Card Address: Credit Card Billing Address: City, State, Zip Code: Phone Number: Contact Name: Card Holder Signature Date 2870 SW 42^d Street, Fort Lauderdale, FL 33312 Phone: - Fax: www.kktransfer.com EFTA00521033