
Air Parcel Express, Inc. 2315 NW 107th Avenue, Unit M1-28, Box 72, Doral, FL 33172
TEL: 305-597-0258 / FAX: 305-592-0266
Credit Card Authorization Form
|
I authorize Air Parcel Express, Inc. to charge my Credit Card from ___________ (Visa, MC, Amex, Discover) with Credit Card number ______________________________________________________________ and expiration _________CVV # ______ Credit Card Billing Address: ______________________________________ ZIP CODE: ___________ I authorize that all charges are subject to weight and measure verification. Should the weight and volume exceed the original estimate I authorize the charges be amended accordingly. Likewise if the charges are less than the tendered weight and measure a credit will be issued. I acknowledge that I am the authorized user of the above credit card account. I authorize use of the above credit card account by Air Parcel Express, Inc. a Federally licensed air and ocean carrier in payment of its invoice. QUOTE # ________________________ AMOUNT TO BE CHARGED $__________________ I acknowledge and understand that the above-referenced is for services rendered on my behalf and at my request by AIR PARCEL EXPRESS. I acknowledge that, by providing this service AIR PARCEL EXPRESS, INC. has met its obligations for the above charge. I acknowledge that this agreement may be cancelled if cargo has not been tendered to carrier and I agree to pay a penalty of 5% to cover transaction fees. If cargo is already tendered to carrier, I acknowledge that this agreement may not be cancelled. Global MAX Agency membership is per calendar year. * I am enclosing copies of my credit card front and back and a picture I.D. * Destination port charges, duties and or taxes are not included. I acknowledge that I have read and received a complete and signed copy of this agreement and of each and every document I have signed including the terms and conditions specified in our air and ocean bills of lading. Signature of Cardholder: _______________________________________ Date: ___________________ In the USA or Abroad FAX 305-592-0266 or TOLL FREE FROM USA 1-877-597-0259. You can print and scan this document also. |