Weston Blinds (c) 2005-2009
A Division of Scippa & Associates Corporation
All Rights Reverved
CREDIT CARD AUTHORIZATION FORM
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Required Field
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Date:
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Card Holder Name
VISA
MASTER CARD
AMERICAN EXPRESS
DISCOVER
BANK CARD
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Card Type
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Card Number:
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MM/YY Format
Expiration date:
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CVV2:
Three-digit number on the back of Visa, Mastercard, Discover and Bank cards
Four-digit number on the front of American Express cards.
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Card Holder Street Address:
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Card Holder Zip Code:
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E-mail Address:
E-mail required to send Receipt & Confirmation
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AMOUNT:
For example: 1,500.00
All credit card payments are processed via TransFirst.com secure server. Merchant Name: Weston Blinds
