Credit Card Authorization
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I hereby authorize Technological Cinevideo Services, Inc. to charge my:
circle card type:
American Express
VISA
MasterCard
In the amount of $_________
as a security deposit authorization
on the equipment;
In the amount of $_________ as
a non-refundable deposit to hold
rental equipment;
In the amount of$_________
as a sale for
rented/purchased/repaired equipment.
Name of Cardholder: ________________________________________________
Signature: ___________________________________________________
Credit Card No.
_____________________________________________________
Expiration date:
Month__________Year_____________
Security Code: _______
Billing Address onCredit Card:_________________________________________
City________________________________State_________Zip_________________
Telephone___________________________Fax_____________________________
FAX THIS ALONG WITH A LIGHT LEGIBLE COPY OF YOUR CREDIT CARD Thank you.
TCS Billing Department
Be aware that the amount authorized as security
deposit will be unavailable for approximately
10-15 business days from date of authorization, after which the security deposit amount
will automatically revert back to your account.
All rental charges are final sales and non-refundable.