Case File
efta-efta00525209DOJ Data Set 9Otherducduc.
Date
Unknown
Source
DOJ Data Set 9
Reference
efta-efta00525209
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
ducduc.
CREDIT CARD AUTHORIZATION FORM
PLEASE PRINT OUT AND COMPLETE THIS AUTHORIZATION AND RETURN IT TO OUR OFFICE BY FAX: (212) 226-5504
CLIENT NAME:
Cardholder Name:
Signature:
Address:
Credit Card Type:
AMEX
VISA
MASTERCARD
DISCOVER
Credit Card Number:
Expiration Date:
Billing Zip Code:
Card Identification Number (last 3 digits located on the back of the credit card):
0000111122223333"999
VISA
Card
Identification
Number
Amount Charged: $
(USD)
EFTA00525209
Technical Artifacts (3)
View in Artifacts BrowserEmail addresses, URLs, phone numbers, and other technical indicators extracted from this document.
Fax
FAX: (212) 226-5504Phone
(212) 226-5504Phone
2223333Forum Discussions
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