Beulah Lambert Sign

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Trucking World LLC.

(Truck Dispatch & Consulting Company)

As per Section
Quote # Consulting Section Quote amount:

Beulah Lambert
BILLTO Cardholder's name 4177
SSN last four : ____________

The services provided by Trucking World LLC are subject to fees as outlined in the terms and conditions
of the service agreement. By accepting the agreement, the customer authorizes Trucking World LLC to charge
the credit card below to cover any additional charges incurred by 3rd party as a result of inaccurate information
provided by the customer. If the credit card is declined, the shipment may be delayed or cancelled.

Card Type:
□ AMEX □ Debit
□ MASTERCARD □VISA
□ Others
Card number: 4305 **** **** 3587

Expiration date (Month / Year): 04-27 Card verification/Security code: 178

Billing address of card: (where you receive your card statements or bills every

month):Street 13 Riverside Garden CT

City: Newark State/Zip/Country: 07104

Phone number: 9735738888 Email address: Beulah64@outlook.com

3587
"I here by authorize Trucking World LLC to charge my credit card ending in [______] for the
consulting services. I confirm that I have initiated this payment and authorized the charge to my
card. I understand that this payment is non-refundable unless otherwise stated by Trucking World LLC."

Cardholder's Signature: Date:

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