Authorization for credit card collection

I,

Authorize my credit card to be charged the following amount:

Type of card:

Card number:

Expiration date: CVC:

Cliente name:

Contact number:

E-mail:

Is important to attach a copy of the credit card, both sides.

Date: Signature:

Ctra. maó - Cala’n Porter, Km. 10 - 07730 Alaior, Menorca - España

Tel. 0034 971 37 72 11
Fax: 0034 971 37 72 18
torralbenc.com