Credit Card Authorization

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Authorization to Charge Credit Card
FAX back to VTP at (818) 566-8989
2721 W. Magnolia Blvd, Burbank, CA 91505

VTP Salesperson: ________________________

I hereby authorize VTP to charge my orders as requested to the credit card referenced below.

  I am authorizing the amount of: Plus Any Shipping/Delivery charges (circle):

For the purchase of: UPS Ground: FedExP1:

UPS Red: FedEx2Day:

Plus Tax (if applicable): Other:

Plus Inbound Freight (if applicable): Insure my shipment for the value of:

I also approve that: a service charge of 2.5 % of the amount charged will be added to my total, canceled
orders are subject to a 20% Restock Fee, and the 2.5% handling fee and all shipping costs are non-refundable.

Cardholder Signature of approval:_______________________________________

Company Name/Ship to:

Address:

City:              State: Zip Code:

Cardholder Name (please print)

Credit Card Type (Visa/MC/AmEx only)

Credit Card Number

Expiration Date If American Express, you must provide your AMEX ID# in this box
(4-digit number printed ABOVE to the right of your Card Number):

You must attach copies of your Credit Card & Photo ID

Additional Instructions

IMPORTANT!

You may print this form, fill it out, and return it with a copy of the front of your credit card and photo driver's license ID to VTP to place your order. Receipt of this form by VTP does not constitute acceptance of an order until a full verification of your order is made, including proof of identity. Your credit card will be charged for any shipping/delivery costs incurred by VTP at the prevailing shipping rates based upon such factors as weight, size, number of pieces, distance, and if special handling or packaging is required, and if you request the shipment to be insured. VTP will only ship domestically within the U.S. to the address of the cardholder.