Empower Network Credit Card Authorization Form PLEASE PRINT OUT AND COMPLETE THIS AUTHORIZATION AND RETURN TO US. All information will remain confidential. Name on Empower Account: Salvador Mateu Empower Network Username: salvamate78. Email: _salvador.mateu78@yahoo.es Cardholder Name: _milagros a perez pena Billing Address for Credit Card: 76 Roseville Dr City: Brampton State/Province: Ontario Country: CA. Zip/Postal Code: L6Y2G8 Credit Card Type: MasterCard Credit Card Number: 5446-XXXX-XXXX-1915, Expiration Date: 01/2016 | mitagros a perez pena authorize Empower Network to charge the ful amount of $2,470.00 to the above listed credit card ending in 1915 for purchase of the Empower Network "Bundles" 228. L, 2 Signature of Cardholder milagros a perez pena Print Name of Cardholder February 27th 2015 Date Purchase Agreement: By signing this form, you acknowledge that your card will be charged a for the Empower Network Bundles. Since this product is delivered digitally, you understand the services are considered rendered at the moment of purchase, and that there are no refunds after our 14-day refund period. In addition, you understand that you are buying products teaching high level concepts to build ANY ‘marketing business. Although these strategies have worked for others, no one can guarantee income or results of any kind. Success comes from hard work, perseverance, leadership, and strategy. Refer to our full earings disclosure for daily, updated average earings at: http:/hwww.empowernetwork.comlincome