ASR ProEvents Inc. Credit Card Authorization Form

Shipping/Event Address:

Name ___________________________________

Address  _____________________________________

City __________________ State ___ Zip Code________

Phone Number ______________________________

   Billing Address (if different that above):

Card Holder ___________________________________

Address  _____________________________________

City __________________ State ___ Zip Code________

Phone Number _________________________________

Credit Card Type (please circle one):  Visa    MasterCard     American Express

Credit card number:  __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

Expiration:  __ __ / __ __  CVV Number __ __ __ __

(This is the 3 to 4 digit number on the back, or front of the card, it is the last numbers in the signature area after the credit card number.)

This form is required for all credit card purchases. 

  
 ** Your order may be canceled without notice if you do not use the exact billing address of your credit card **
 
ASR PROEVENTS, INC. IS AUTHORIZED TO CHARGE OFF ALL FINAL BALANCES, ADD-ONS, LATE FEES, AND/OR ANY DEPOSITS, SECURITY DEPOSITS, AND/OR ANY INCURRED DAMAGES OR LOSSES TO THE SAID RENTAL ITEMS (THAT ARE NOT COVERED UNDER RENTERS EXISTING INSURANCE) TO THE FOLLOWING CREDIT CARD. PLEASE NOTE THAT BILLING ON YOUR STATEMENT WILL READ PAYABLE TO, A-1 STUDIO/ASR BACKLINE. PURCHASES OVER $501.00 USD, WILL BE ASSESSED A 2.5% SURCHARGE TO THE TOTAL AMOUNT OF THE CHARGE AND CHARGEBACK'S ARE SUBJECT TO ADDITIONAL LATE FEES AND PENALTIES.

ALL PURCHASES OVER $501.00 U.S., WILL BE ASSESSED A 2.5% ADMIN CHARGE TO THE TOTAL AMOUNT OF THE INVOICE/PROPOSAL.

I Authorize ASR ProEvents Inc.  to charge my credit card in the amount of $_______________  (before admin fee)

(purchases over $501.00 assessed a %2.5 admin fee to total amount due)

For Invoice / Proposal / EBAY Item# : _______________ 

Card Holder Signature _________________________________    Date __ __ / __ __ / __ __

PLEASE PRINT LEGIBLY, AND COMPLETE ALL ABOVE INFO, INCLUDE A LEGIBLE AND ENLARGED COPY OF FRONT & BACK OF CREDIT CARD!

ASR ProEvents Inc. of Florida 800 Waterway Place Longwood Florida 32750-3573 USA 

Please FAX back to either of the below FAX numbers

407-767-0161 FAX   /  407-641-9368 EFAX

Questions, Concerns? Call 407-767-5776 x101