Sales Order or PO#
Credit Card Type:
Credit Card Number
Name on Credit Card
**If you would like this card kept on file for future orders please leave the “Amount of Purchase” field blank
This agreement shall authorize Twin-Star to charge card holder’s credit card for all purchases of Twin-Star products, shipping costs and services, “products. Cardholder acknowledges and agrees to the following terms and conditions:
This completed request for credit card approval must be faxed to Twin-Star International along with the following items prior to Twin-Star processing Credit Card Authorization request.
Twin-Star will maintain copies of credit card and ID on file for future orders.
Signature of Card Holder*
[signature signature cols:500 rows:250 background:#efefef]
PLEASE COMPLETE THE ATTACHED CERTIFICATE OF EXEMPTION FORM.
NOTE: A SELLER’S PERMIT OR A COPY THEREOF CANNOT BE SUBSTITUTED FOR THE CERTIFICATE OF EXEMPTION FORM. THE FOLLOWING STATES MUST PROVIDE STATE PRESCRIBED FORMS: HAWAII, INDIANA, LOUISIANA, MASSACHUSETTS, NEW YORK, NEW JERSEY (MAY BE REPRODUCED FOR N.J. ONLY).
I HEREBY CERTIFY:
Tangible personal property for resaleTangible personal property purchased for incorporation as an integral part or component part of a product manufactured for resaleOther
In the event any of the above listed property is used for any purpose other than retention, demonstration, or display while holding it for sale in the regular course of business, it is understood that I am required by the Sales and Use Tax Laws to report and pay tax measures by the purchase price of such property or other authorized amount.
Legal Business Name (as Registered with State)
Trade Name (dba)
Bill to Address, Street
City, State, Zip
Signature of purchaser or [signature signature-purchaser cols:500 rows:250 background:#efefef]