cardform

Card Authorization Form

Billing Name
Billing Address
Must match card
Credit Card Type(Required)
I agree to charge the agreed amount listed above to my credit card provided herein. I agree that I will pay for this purchase in accordance with the issuing bank cardholder agreement.
Max. file size: 256 MB.
Upload a photo of your ID front.
Max. file size: 256 MB.
Upload a photo of your ID back.
Max. file size: 256 MB.
Upload a photo of your card you are using.
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