PaymentTents Tarps Manufacturer2020-07-01T17:26:52-05:00 CREDIT CARD PAYMENT AUTHORIZATION Need to Pay by Credit Card? Download our Credit Card Payment Authorization Form Name* First Last Email* Enter Email Confirm Email Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date* Date Format: MM slash DD slash YYYY * I authorize, as indicated by my signature, Custom Tents and Tarps, LLC to charge the credit card indicated in this authorization form according to the terms outlined above. This payment authorization is for the goods/services and for the amount discussed only, and is valid for one time use only (unless indicated otherwise). I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; as long as the transaction corresponds to the terms indicated in this form. Our Tarps & Tents are Built to Last Call For Pricing 918-219-5572