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America’s Private Investigation Network, Inc.
Headquarters: 1728 Main Street, Columbia, South Carolina 29201
CREDIT CARD AUTHORIZATION FORM
(Visa or Master Card Only)
Date:______________________
I authorize America’s Private Investigation Network Inc. to bill the following credit card:
Credit Card Number:____________________________________________________
Expiration Date:________________________________________________________
Driver’s License Number/State:____________________________________________
Total Amount is:_______________________________________________________
Name as it appears on credit card:_________________________________________
Card Holder Signature:___________________________________________________
Mailing Address of Credit Card:____________________________________________
_____________________________________________________________________
Authorization Number:___________________________________________________
IN ADDITION TO THE ABOVE INFORMATION, A COPY OF THE CREDIT CARD HOLDER’S SIGNATURE FROM EITHER THE BACK OF THE CREDIT CARD OR VALID DRIVER’S LICENSE MUST ACCOMPANY THIS LETTER OF AUTHORIZATION.
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