Butcher's Block | Big Bear Lake, CA | Credit Card Charge Authorization

Credit Application

Credit Card Charge Authorization

BUTCHER’S BLOCK & BUILDING MATERIAL - CREDIT CARD CHARGE AUTHORIZATION

Card Type

Visa

MasterCard

Discover

Credit Card #

Card Expiration Date

CVC Number on Back of Card

Starting Effective Date

Ending Effective Date

Name on Card

Billing Address

City

State

Zip

Cardholder Phone Number

Cardholder Email

Person/s Authorized to Use This Card:

Jobsite Address

City

State

Zip

I hereby authorize Butcher's Block and Building Material at 41860 Big Bear Blvd, Big Bear California 92315 to charge purchases made by:

Authorized Users

to the above credit card.

Signature of Card Holder

Card Holder Name

Date

This is a Credit Card Charge account ONLY, not a Butcher's Block house charge account. The customer and/or the customer's employees are responsible for keeping their receipts and all records. There are NO refunds without a receipt. Butcher's Block and Building Material is relieved of all responsibility for the customer's record keeping.

Thank You! YOUR CHARGE AUTHORIIZATION HAS BEEN SUBMITTED! PLEASE DO NOT RE-SUBMIT