AUTHORIZATION
TO CHARGE CREDIT CARD
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Company Name: |
<-- please fill in |
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Email Address: |
<-- please fill in |
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Name On Card: |
<-- please fill in |
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Credit Provider: |
<-- please fill in |
| Credit
Card Number: |
<--
please fill in |
| Expiration Date: |
<--
please fill in |
I authorize American Technical Solutions,LLC
to debit my credit card as a monthly recurring
charge for services rendered at agreed published
prices. Any charges made to the credit card
above under this agreement will constitute
in effect a "sales receipt"; and that services
were rendered and received. Should I dispute
a charge through my credit provider this will
constitute a breach of this agreement and
will result in immediate deactivation of all
current services.
Signature
______________________________________
Date ________________
INSTRUCTIONS
Please print, sign, date, fax or email to
American Technical Solutions, LLC (703-991-6253)
-agreements@wedoallthatstuff.com.
Mail original to ATS at address included below.
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