1 Contemporary Furniture

Credit Card Authorization Form

Please print and fax to: (843) 706-9913.

Customer authorization for a payment by credit card.

I, _____________________________,
(Please print your name)
the undersigned authorizes 1 Contemporary Furniture to charge my credit card for the purchase of furniture or accessories.

The payment is made by ( ) Master Card ( ) Visa ( ) Discover, numbered _______________________ and expiring on _______ with security code__________(3 digit code on back) 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. A 20% restocking fee will be charged for returned items.

Signed this ________ day, ________ month, ________, year

__________________________________________
(Signature)

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