Credit Card Form - Blackbird Worldwide

1. Type of Credit Card*:

MasterCard Visa American Express Other

2. Company Name*:

3. Name on Credit Card*:

4. Credit Card Number*:

5. Credit Card Expiration Date*:

6. Billing Address*: Street Address, City, State and Zip Code

7. Name, Phone or Email*: This is a way to contact you if we need more information.

8.Please Indicate Your Blackbird Worldwide Salesperson or Blackbird Worldwide Contact*:

9. AUTHORIZATION *: For my convenience, I am authorizing Blackbird Worldwide Transportation Services to execute transactions for transportation services on my credit card listed above. By executing this form, it will not be necessary for me to sign each credit card voucher. This authorization is valid until such time as written notice of revocation is received by Blackbird Worldwide Transportation Services

I accept I don't accept

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A. Company Information

Company Name: NA
Name on Credit Card: NA
Credit Card Type: NA
Credit Card Number: NA
Expiration Date: NA / NA
Billing Address: NA
Name, Phone or Email: NA
Salesperson or Contact: NA

Credit Card Authorization

Credit Card Authorization

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A. Company Information