PRE AUTHORIZATION FOR CREDIT CARD PAYMENT

Date: ___________________

Company Name: ________________________

Authorizing Name: __________________________________

Telephone: ________________________________

Street Name: _____________________________

City: ___________________

Province: _______________

Postal Code: _____________

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I authorize ClassicBrand Cabinetry to debit my credit card with the amount due shown on my statement/Invoices: A 2%
surcharge will be added to the total amount of each invoice.

I authorize ClassicBrand Cabinetry to debit my credit for all overdue invoices, the dealer will be notified prior to
processing a payment.

Payment Terms: Due on receipt of invoice, if there are special terms given, they will be sent by E Mail from ClassicBrand.

In the event that a credit card payment is declined or defaults the dealer agrees to forward payment by E Transfer upon
request from ClassicBrand. If the amount is greater than the dealer’s payment limit, a cash payment for the balance is
required.

E Transfer address : ar@classicbrand.ca

VISA or MasterCard

Card Name: ____________________

Card Holder’s name: ________________________

Credit Card #: _______________________________________

Security Pin #: ___________

Expiry Date: _____________

Card Holder’s Signature: ________________________________

Date Signed: ____________