Martin Manufacturing, Inc. Credit
Card Order Form Date of
order:________________________________ Ship
via: (circle one) Fed Ex Freight - DHL
Shipping costs are $20.00 per scooter DHL shipment. Please specify DHL, or Fed Ex Freight. Fed Ex Freight requires a rate quote for your area. The most economical method will typically be chosen based upon order quantity and needed delivery date. As a reminder, due to production schedules your exact request may not be shipped but, any items not included in your original request will be included on a subsequent invoice. By signing below, I authorize Martin Manufacturing to charge my credit card choice selected below. I authorize the amount necessary to place the order above and to ship it to my dealer address. If there is a conflict on the invoice or an issue with product, I will contact Martin Manufacturing by voice or in writing to resolve any issues. I agree to not make any charge backs on my credit card until I have contacted Martin Manufacturing to resolve the issue in question. I understand that Martin Manufacturing will not charge my credit card until the shipment is ready to leave the plant. American Express / Visa / MasterCard Credit card #:_______________________ Exp. Date:_______ (Circle One!) Keep on File - DO NOT KEEP ON FILE! - Use as alternate card American Express / Visa / MasterCard Credit card #:_______________________ Exp. Date:_______(Circle One!) Keep on File - DO NOT KEEP ON FILE! - Use as alternate card Cardholder
Name:__________________________________________________ |
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