Authorization To Charge Form

Please print all lines legibly

Your Name: __________________________________________________BrandComet Project / Invoice #: __________________

Company Name: ______________________________________________Total Amount: $ _____________________

Shipping Street Address: ________________________________________________________________________

Street Address 2: ______________________________________________City: __________________________ State: ____ Zip: ____________

Phone: _________________________________________ Fax: __________________________________

Email: ____________________________________________________________

Credit Card Information

Credit Type (Circle One): Visa . MasterCard

Credit Card Number: ____________________________________________________________________

Individual Cardholder's Name on Card ( not company name ): __________________________________________________________________________

Exp. Month / Year: _______ / _______ ; 3 digit code on far right of back side: __________

Cardholder’s Billing Street Address: ________________________________________________________________________

Cardholder's Street Address 2: ______________________________________________________________________________________

Cardholder Billing City: __________________________ State: ____ Zip: __________

By signing this document, you authorize BrandComet to charge the above credit card for the total amount stated on the Invoice including shipping and any prorated quantity variance. All deposits for custom products are non-refundable. There are no cash or credit card refunds without written prior authorization from BrandComet. The amount stated on the Invoice is to be paid and the consumer can issue no charge backs with all sales final. You are authorizing BrandComet to ship the stated order to the stated address(es) and agreeing to receive the shipment and to pay the shipping and handling cost. Note: you agree receipt is defined as receipt by anyone at the stated address(es) regardless whether the address is listed as an alternative address on credit card file or not. Any dispute or dissatisfaction regarding any services or product shall be addressed directly with BrandComet and any claim with the issuing credit card company resulting in a charge back to BrandComet shall constitute a Breach of Agreement or Contract as witnessed by your signature below. Credit card information is kept totally confidential and will not be released to any other party other than for BrandComet’s use in executing the order and charge. This is to protect you and BrandComet from fraudulent charges made by anyone who is not authorized by you. The signatory individually guarantees payment in the event that the credit / debit account charge is denied, rejected, or not paid for any reason. In the event of dispute, the forum and situs for any action shall be Orange County, Florida. The signatory individually, and the cardholder jointly and severally, guarantee the faithful payment of the said sum together with all costs of collection, attorney’s fees, court costs and other costs, and together with all delinquency charges and finance charges during any period the amount due remains unpaid in full; and waive service of process and all notice of dishonor or default. This guarantee may not be revoked, altered, or amended without the express written agreement of BrandComet.


____________________________________________________________ Date : ____________________

By signing above, you indicate your acceptance of the order information on the above-designated invoice / order acknowledgment as complete and accurate. Any changes to order after signing, if accepted, will incur a $25. change order fee in addition to any other applicable costs and fees. Further, by signing above, you agree in full to all aspects of BrandComet’s standard sale terms and conditions (current and as may be modified in the future, which are either attached, provided previously or available upon request) and authorize BrandComet to charge your credit card in full including shipping and handling cost and any prorated quantity variance for this order.