To Pay an invoice by Credit Card
Copy and Paste the following into an email, Filling in the needed details.

 

 

Jensen Entertainment Inc.

PO Box 72065

Roselle Illinois 60172 -630-351-1500

Please email or fax back sign copy to:

jim@magical1.net or 630-206-2339 (fax)

 

 

Jensen Entertainment Inc. Credit Card Authorization Form

Credit Card Account Authorization

 

Issuing Bank_____________________    Telephone #______________________

 

Credit Card Type Visa/MasterCard  Account Number: _______________________                         

Expiration Date: __________________

 

Security Code: ____________________

 

Invoice Number #         ________________

 

Cardholders Billing Name & Address              

Name __________________________              

Street__________________________               

_______________________________              

City____________________________            

State__________Zip_______________

                                                         

Statement of Authorization

 

The purposes of this statement, is to authorize Jensen Entertainment Inc. (also state forward as "the merchant") to process credit card transactions from the above stated applicant.  These Transactions will be processed via phone orders.

 

I/we have read and agree to be bound by the Terms, Conditions, & and cancellation Rules in the Jensen Entertainment Inc. Sales contract & Invoice.  I/we will not request a charge back through my/our credit card without first obtaining authorization from Jensen Entertainment.  In addition, by signing this document I/we am/are accepting all responsibility for these transactions to ensure full and proper payment to the merchant.

 

Total Amount To Be Charged $__________ for the 50% deposit

 

Total Amount To Be Charged $__________ for payment in full

.

Cardholder acknowledges the amount shown above and agrees to perform the obligation set forth in the Cardholder's agreement with the issuer.

 

________________________          _____________________      ____/___/___

Name (type or print clearly)       Authorized Signature                      Date