KHutch Investigations

Credit Card Authorization

Please fill out this credit card authorization completely, providing all the required information. Print the form and mail to: KHutch Investigations P.O. Box 508 Lewisville, NC 27023  The charges on your credit card statement will be from KHutch Investigations
Information Exactly As It Appears On The Credit Card
 Name On Card:
Billing Address
City
State
Zip
Billing Phone:
Email Address:
Fax Number
Card type
 Expiration Month/Yr  
CVC on back
   
Issuing Bank
Authorized Amount

Comments
 * Not to exceed amount
  
* In the event a Not to Exceed amount is selected, your charge amount will not exceed that limit, however your request for service may be delayed, pending a new authorization form, if additional charges are necessary due to unexpected expenses or other charges.

Carefully read the terms below.  Must be signed and dated in order to be valid.

I Hereby authorize KHutch Investigations to charge my credit card for services rendered, up to the amount stipulated in a 30 day period.  I understand, in the event of chargeback, or the failure for the credit card provider to pay the charged amount, I am personally responsible, for full payment for services rendered plus any late fees and collection costs.

Signature:
 Date:

©2009 KHutch Investigations