CUSTOMER CREDIT CARD HOLDER AUTHORIZATION TO SHIP TO ANOTHER ADDRESS

Dear Customer, To protect the use of your credit card, we ask that you complete the following form. If you'd like to use more that one card, please use a separate form for each card.

Instructions:

1) Please type or print clearly.

2) Fill out form completely, sign and date. 

3) Fax completed form to 850-665-3416 or mail to the address provided on the right.

 

SNEDCO WHOLESALE
Dept. 283
1049 E JOHN SIMS PKWY, STE 2
NICEVILLE, FL 32578
Phone: 850-665-3796 or Fax: 850-665-3416
Email: support@snedco.com
Website: www.snedco.com

Billing Information:

Cardholder’s Name ________________________

Address _________________________________

City, State, Zip ____________________________

Telephone _____-_______-____________

Fax _____-_______-____________

Email _________________________________

 

Shipping Information: (if different from billing)

Business Name ___________________________

Address _________________________________

City, State, Zip ____________________________

Telephone _____-_______-____________

Fax _____-_______-____________

Email _________________________________

 

 

Name on Credit Card

 ________________________________________

 

Last 4 Numbers of Credit Card   ___ ___ ___ ___

 

Expiration Date ____________________________

PLEASE NOTE… You will need to provide your full credit card number each time you place an order with us.

 

 

Dear SNEDCO WHOLESALE,

This is to advise you that I plan to take advantage of your drop ship program. SNEDCO WHOLESALE is hereby authorized to charge the cost of my order to my credit card account listed above and ship the merchandise to the address I provide on my order form either through your website, phone, snail mail or by fax. I understand that SNEDCO WHOLESALE may reserve the right to limit the quantity and/or amount of a shipment to protect all parties involved. I also understand that by signing this form, I am agreeing to the terms and conditions set forth by SNEDCO WHOLESALE. 

 

Cardholder’s Signature _______________________________________      Date __________________________