Credit Card Authorization Form

TITAN MARINE AIR NV

Please complete this form to authorize Titan Marine Air Nv to make a one time charge to your credit card listed below. By Signing this form, you give us permission to debit your account for the amount indicated on your final invoice. This is permission for a single transaction only, and does not provide authorization for any additional debits, unrelated debits or credits to your account.

Please select the correct card:*
VISAMASTER CARDDISCOVERY NETWORK

Amount charge(US Dollar) (If Amount is not known, put "as per final inv")*

Credit Card Authorization Agreement:

I authorize Titan Marine Air NV to charge the credit card listed in this authorization form according to the terms herein. 3.5% merchant fee applies with the use of a credit card . All parts to be paid in full upon order. Shipping and labour to be paid on completion of work. 25% re-stocking fee on all returns. Electrical components are not returnable. This payment Agreement and Authorization is for the goods/services described on the final invoice and for the amount indicated only. I hereby authorize Titan Marine Air NV to charge the credit card—with no further authorization or approval from me—if payment is not done directly within 3 days after the final invoice is sent to me by Titan Marine Air NV. This is valid for a one- time use only unless otherwise agreed to by me. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company, so long as the transaction and charge corresponds to the terms indicated in this form.
From Titan Marine Air Nv

By clicking this box, you are agreeing to and authorizing Titan Marine Air NV to charge your credit card in accordance with the terms of the Credit Card Authorization Agreement

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