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VISAMASTERCARDAMERICAN EXPRESSDISCOVER

Name on Credit Card: *

Credit Card Number *

Expiration Date *

Security Code *

Billing Address *

Billing Zip Code *

I, the undersigned, hereby authorize All American Limousine, Inc., to charge the above listed credit card account the amount indicated on all orders I approve by fax receipt, or my signature (anyone authorized by me to sign) at the time of receipt, and that I will in good faith, make good on the above charges. I do hereby personally guarantee payment of the event of a charge-back or non-payment without just cause, by All American Limousine, Inc. My signature is proof that I knowingly submitted this credit card information as valid & true. My signature denotes that I understand & authorize personal and/or the corporate use of this credit card for future services to be rendered without any or other signatures.