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		Secure Credit Card Autorization Form

Credit Card Authorization Form

Authorization to charge credit card
I authorize Memphis Travel to charge to the following described credit card the amount of as payment in connection with .
Card Holder's Name on card
Credit Card Type
Credit Card Number		CVV	what is CVV?
Expiration Date	Month: Year:

Card Holder's Contact Information
Full Name
Street Address
Zip Code
State / Province
City
Country
E-mail

By checking the box I authorize Memphis Travel to charge my credit card with the amount shown above.

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