ALL INFORMATION MUST BE THE CARDHOLDER'S. PLEASE PRINT, FILL OUT AND EMAIL BACK TO INFO@THESTYLELISTLA.COM

 CARDHOLDER

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 PROJECT

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CREDIT CARD BILLING ADDRESS

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 CITY _____________________________________ STATE ____________

 ZIP_____________________ CELL ____________________________________           

HOME___________________________________

 EMAIL _________________________________________________

 I hearby authorize permission to __________________________________________________to make charges at THE STYLE LIST on my credit card.

CREDIT CARD#___________________________________________________________ (MASTERCARD, VISA, AMERICAN EXPRESS, DISCOVER)            

 EXPIRATION ______________________________________            

 SECURITY CODE________________________________

 *REQUIRED* PLEASE ATTACH A COPY OF THE CREDIT CARD & DRIVER’S LICENSE OF THE CARDHOLDER

 I authorize any loss and / or damages, late rental fees, alterations, labor, dry cleaning, shipping & handling to be charged on the above credit card supplied.

CHECK BOX TO RETAIN CREDIT CARD FOR OUR PERMANENT FILE

 

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Signature of card holder                                                                                  Date

 

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 Print name of card holder