1 Contemporary Furniture

1 Contemporary Furniture
CREDIT CARD AUTHORIZATION FORM
Fax to: (843) 706-9913

Authorization Form for a payment by credit card.

I, _____________________________
(Please print your name in capital letters), the undersigned authorizes Contemporary Designs Ltd, Inc. to charge my credit card for the purchase of furniture.

The payment is made by ( ) Master Card ( ) Visa ( ) Discover, numbered _______________________ and expiring on _______ with security code__________(3 digit code on back of most cards), in the amount of $ ____________.

I have read the Shipping and Return policy posted online and I agree to the terms and conditions. I agree that orders for custom made furniture are final. No returns on custom made furniture. A 20% restocking fee will be charged for returned items.

Signed at: __________________________________ This _____ day of ________ 2010

__________________________________________
(Signature)

__________________________________________
(Print name in capital letters)
Duly authorized as so he (she) declares

1 Contemporary Furniture
www.1contemporary.com

27 Dr. Mellichamp Drive, Ste 100
Bluffton, SC 29910 (USA)
Tel: Office (843) 706-9903 | Fax: (843) 706-9913 | Showroom (843) 706-9960
info@1contemporary.com