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Bargain Crusader
2841 Index Rd. Ste 200
Madison, WI 53713 Phone: 608-663-9001 Fax: 608-270-1193 Email:bargaincrusader@tds.net
Website: www.airsoftgunsusa.com

Credit Card Authorization
Fax copy of sellers permit, and credit card (front & back) provided with first order.
If using different card in future will need new copy of credit card.

Business Name: __________________________________________________________
Contact Name: ___________________________________Phone: _________________
Shipping Address: ________________________________________________________
City: ______________________________ St: _____ Zip: ______________________
Billing address ( ) if same as shipping "X"
Cardholder Name: __________________________________Phone: _______________
Shipping Address: ________________________________________________________
City: ______________________________ St: _____ Zip: _______________________

Credit Card: Discover, Master Card, Visa (circle one)

Credit Card #____________________________________________________________
Expiration____________________ CVV Code on back of card (last 3 digits)__ ___ ___
By signing card holder ( here in called signer) agrees to the following :
Signer is person with authority to have charges against provided credit card.
Card holder will assume shipping and handling fees for any returned product.
Signer gives Bargain Crusader authorization to charge credit card for product ordered, and related shipping and handling fees.
Credit Card Holder Name (print): ____________________________________________
Credit Card Holder Signature: _______________________________________________

Date: _______________