AUTHORITY TO CHARGE CREDIT CARD

PLEASE PRINT ALL OF THE REQUIRED INFORMATION BELOW 

AND SIGN TO AUTHORIZE HUSHCO BUTTONS TO CHARGE YOUR CREDIT CARD

       

Name on card
Billing Address

Postal Zip Code            Country 
Credit card  Number     Expiration date     Type of card            3 or 4 digit code**

** you can find the 3 or 4 digit code on the back, or front (AMEX) of your card
SIGNATURE

Your signature implicitly indicates that the above credit card is issued to you, and that you are the authorized user.  Your signature authorizes Hushco Buttons to charge your credit card for items purchased and/or services rendered.  You agree to pay the total amount according to card issuer agreement.
E-mail

WE REQUIRE YOUR ACTUAL SIGNATURE ON FILE.  PLEASE PRINT THIS PAGE AFTER YOU HAVE FILLED THE BOXES, SIGN AND FAX TO 213 746 8444, OR EMAIL TO CUSTOMERSERVICE@HUSHCOBUTTONS.COM.