TKT Sales (800)-997-4858 Phone

850 Dunksferry Road (215)-244-0748 Fax

Bensalem, Pa 19020

Credit Card Authorization Form

I ______________________________ hereby authorize TKT Sales to charge our
credit card in the amount not to exceed $______________________USD.

Visa MasterCard

Card Number ____________________________Exp __________3 Digit _____

Name exactly as it appears on the card ________________________________

Credit Card Billing Address ______________________________________________

____________________________________________________________________________

Requested Shipping Address ____________________________________________

____________________________________________________________________________

Blanket Authorization valid until ____________

Dollar limit for blanket authorization $___________ (none if left blank)

One Time Charge

Print Name ______________________________________

Authorized Signature ____________________________

Phone #___________________________________________