Credit Card Authorization From

I, , hereby authorize International Aviation, LLC, to charge my credit card account in the amount not to exceed :

$

Visa   Mastercard  
American Express   Discover

3% Visa/MC/Discover.      
4% Amex fee.      
Fee Non-refundable

Card Number

Expiration Date /

Security Code:

Credit Card Billing Address :

Name on Card

Company Name

Street :

City :

State :

Zipcode : -

Country ( if not us ) :

Telephone :
() - -

Requested Shipping Address

Company Name

Street :

City :

State :

Zipcode : -

Country ( if not us ) :

Telephone :
() - -

As the credit card holder, I hereby authorize receipt of goods and services at the shipping address above.

Cardholder's Signature Clear

Date (DD/MM/YYYY)

As the credit card holder, I also authorize International Aviation, LLC to charge my credit card for future purchases or additional charge approveed by me.


Authorization Valid Untill :
/

Initials Here: