CREDIT CARD AUTHORIZATION FORM

Watcon will only ship to the cardholder’s billing address if using a credit card as form of payment.  If you would like to have your order drop shipped to another address please send us a wire transfer. (Information at bottom of this page)

Instructions:

1. Complete the form by printing legibly, in the blanks below.

2. Credit card holder’ must sign on the line indicated.

3. Include a photocopy of the front and back of the signed credit card and cardholder’s driver’s license (make sure image is legible)

4. Fax this and all forms, along with the photocopy of the signed credit card and drivers license, back to our secure fax machine at 360 692-2285

I, _________________________________________________, hereby authorize Watcon.com. to charge my credit card.

Type of Card (circle one):   VISA    MASTERCARD     AMEX    DISCOVER

Credit Card # ____________________________________ Expiration Date _ __   /______

CVV Code (last three or four digits on the number on the back of the card) ______________

Bank Name ________________________                                                                     Telephone # (         )_____________________

Credit Card Billing Address

Street: __________________________________________

City: ____________________________________          State: _________                                Zip Code: ____________                      Telephone: (        ) ________________________

As the credit card holder, I hereby authorize Watcon.com. to charge my credit card.  I have read and agree to all the terms and policies of Watcon.com

Cardholder’s Signature _______________________________________________

Date   __   _/___   _/_______

Cardholder’s E-mail address _______________________________________________

Your completion of this authorization form helps us to protect you, our valued customers, from credit card fraud. All information entered on this form will be kept strictly confidential by Watcon.com.

Wire Transfer Information: