CUSTOMER CREDIT CARD AUTHORIZATION FORM



Order# (Required):______________  



Please print name EXACTLY as it appears on card: _________________________



Company: __________________________  Tax ID Number __________________



Billing Address of Card Holder:  



Address:  _________________________________________________



City _____________________________ State _______________ Zip __________



Shipping Address (if different than Billing Address):



Address:  _________________________________________________



City _____________________________ State _______________ Zip ___________



Phone Number (______) ________________ Fax Number (___) ________________



E-Mail Address ________________________   



Card type:   ______________________ (Visa/MC/AmerExp/Discover)



Credit Card No. __________________________  Exp _______(mmyy) Card Id No._____





PLACE FRONT OF                                     PLACE BACK OF 

CREDIT CARD HERE                                   CREDIT CARD HERE  





(Light and legible copies of the front & back of the credit card and ID are required with this form) Dark copies are rejected. If you need more room, copy credit card on a separate page.  Sign that page as well.



COPY OF DRIVERS LICENSE HERE









I do hereby authorize Sadoun Satellite Sales to process payment for all orders,

made by fax, phone or email, to the above referenced credit card. I assume

responsibility for all payments pertaining to my account and do state that I am

the cardholder.  I have included a copy of the front & back of the credit card

and understand if the copy is not received; the orders will not be processed.

I do also agree to abide by the Sales & Return Authorization Policies

established by Sadoun Satellite Sales. I have read the above conditions & 

hereby agree to the terms of this sale.



Authorized Signature ___________________________  Date ______________________

Fax to 1-614-529-9570 &  Mail original to: Sadoun Satellite Sales, New Accounts

Dept., 2747 Westbelt Dr., Columbus, OH 43228, USA   

If you have any questions, please call 888-519-9595