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oofos credit card autho form 100%

                 ☐        VISA                  ☐        MASTERCARD       ☐ AMERICAN  EXPRESS     Credit  Card  number______________________________________________________________Expiration  Date________________       CVC  Code  (last  three  digits  on  the  back  of  the  card)  ____________________________________     Cardholder  Name  (please  print):________________________________________________________________________________     CREDIT  CARD  BILLING  ADDRESS         REQUESTED  SHIPPING  ADDRESS     Street:____________________________________     Street:

https://www.pdf-archive.com/2016/06/06/oofos-credit-card-autho-form/

06/06/2016 www.pdf-archive.com

pci dss saq 99%

45 questions to be completed Protect Cardholder Data :

https://www.pdf-archive.com/2017/05/02/pci-dss-saq/

02/05/2017 www.pdf-archive.com

CC Procedure & Agreement 98%

Being a TiqIQ cardholder is a special privilege.

https://www.pdf-archive.com/2016/08/20/cc-procedure-agreement/

20/08/2016 www.pdf-archive.com

Table Reservation Agreement - Drop 87%

Cardholder Name: ... Cardholder Signature: ... (if different from cardholder) Date:

https://www.pdf-archive.com/2016/05/17/table-reservation-agreement-drop/

17/05/2016 www.pdf-archive.com

ICC Banking Annual Meeting Exhibition Order Form 2018 2 84%

_______________________________________________________________ City _________________________________________ State ___________ Zip Code ________________ Credit Card Holder (Print Name as it appears on card) ____________________________________________ Card Holders Signature _______________________________________ *****Cardholder hereby authorizes EXPO to charge credit card described herein for all charges incurred by Exhibitor and has read, understands, and agrees to all forms in the exhibitor manual and agrees to pay all charges as described in Cardholder Agreement.

https://www.pdf-archive.com/2017/12/08/icc-banking-annual-meeting-exhibition-order-form-2018-2/

08/12/2017 www.pdf-archive.com

fundraiserapp-docwilliams (5) (1) 83%

Second Household Cardholder must reside at the same address as the Primary Cardholder.) Last Name ___________________________________ First Name _________________________________ MI ___________ _________________________________________________________________________________________________________ Primary Signature — I understand that I am responsible for any checks and actions of the Second Cardholder.

https://www.pdf-archive.com/2017/04/05/fundraiserapp-docwilliams-5-1/

05/04/2017 www.pdf-archive.com

Credit Card Authorization 80%

Visa MasterCard Discover Cardholder Name _________________________________________________ Account Number _____________________________________________ Expiration Date ____________ CVV2 (3 digit number on back of Visa/MC ) ______ CARDHOLDER SIGNATURE ___________ DATE I authorize the above named business to charge the credit card indicated in this authorization form according to the terms outlined above.

https://www.pdf-archive.com/2013/02/18/credit-card-authorization/

18/02/2013 www.pdf-archive.com

TSS Reservation Form 80%

  The Supporters Section  416.458.2266  info@TheSupportersSection.com  March 14­15, 2015. Toronto FC v Columbus Crew  Booking Request Form    OCCUPANCY/PRICE  INCLUSIONS  Quad    ⬜  ​ 4 person room package  $125.00 p/p   =  $500 CAD Total  Triple    ⬜  ​ 3 person room package  $145.00 p/p   =  $480 CAD Total  Double  ⬜  ​ 2 person room package  $165.00 p/p   =  $330 CAD Total  Single   ⬜  ​ 1 person room package  $235.00 p/p   =  $235 CAD Total  Includes: Return bus transportation from Toronto to  Columbus Ohio, hotel accommodation in chosen occupancy,  transfers to/from hotel to game, exclusive­unique  anti­Columbus Crew flag.    LEAD PASSENGER INFORMATION (PLEASE PRINT LEGIBLY)  First Name:_________________________________________​  ​ Last Name:___________________________________________​      ​ ⬜ M ⬜ F    Email:_________________________________________________________​  ​ Phone: (       ) ______________________________      Street Address:___________________________________________​  ​    ​ City:_________________________  Province:___________      Postal Code:__________ / _______​  ​  Date of Birth: ______/_____/_____    Note: The lead passenger must be over the age of 18.      I, the above stated passenger, am responsible for this reservation and will be the main contact for my room   I confirm this information is correct and that I have reviewed the Terms & Conditions.      Passenger Signature:______________________________________________________________   Date:_______/_______/_______      ROOMING       First Name:   Last Name:  Email:  Roommate 1        Roommate 2        Roommate 3        Roommate 4            PAYMENT INFORMATION  Cardholder Name: ​ ________________________________________     ⬜​  ​ Visa​   ⬜ ​ Mastercard​  ⬜​  ​ American Express      Card #​   __/___/___/___/___/___/___/___/___/___/___/___/___/___/___/___/      ​  Expiry​  _____/_____  ​ CVC ​ ___/___/___/___    Deposit: $50 CAD per passenger due upon registration.    # of passengers  ______ x $50CAD  = $_______ CAD  Total Amount Due   # of passengers ____ x Room Occupancy ___________CAD = ________CAD  ­ deposit of $_________  =  $_________CAD    Balance Due Amount: $______________CAD required February 14, 2015         Date:   ___________________________            Cardholder Signature :   ___________________________________          The Supporters Section is a division of ilovetravel    337 Queen Street West, Toronto, Ontario, Canada, M5V 2A4 | Tel: 416.966.0909 | TICO Registration No.50015962     

https://www.pdf-archive.com/2015/01/28/tss-reservation-form/

28/01/2015 www.pdf-archive.com

Registration OASISC2 Coding SharonM Final-10.25.16 78%

7714-229-8700      Part 5:      Tuesday December 13, 2016    Respiratory and Cardiac Status:  M1400‐M1511  Elimination Status:  M1600‐M1630  Neuro/Emotional/Behavioral Status:  M1700‐M1750  ADL/IADLs:  M1800‐M1910 and GG0170C  *Note:  Not all data items will be addressed      Part 6:       Thursday December 15, 2016    Care Management:  M2102 and M2110  Therapy Need and Plan of Care:  M2200 and M2250  Emergent Care:  M2301 and M2310  Transfer and Discharge:  M2401‐M2430; M0903 and M0906  Q&As  *Note:  Not all data items will be addressed    METHOD OF PAYMENT  ⃝    Name on Card:      Card Number:       Security Code:      Cardholder’s Address    City / State / Zip Code    Cardholder’s Signature  Visa  ⃝  Mastercard  ⃝  American Express  ⃝  Discover  _______________________________________ _______________________________________   _______________________________________   Expiration Date:_____________  _______________________________________   CVV Code: _____________  _______________________________________   _______________________________________    _______________________________________     Cancellation Policy:  All approved cancellations/refunds are subject to a $50 administration fee to offset system and financial charges. Refunds will be credited back  to the original credit card used for payment. This fee is based on per transaction. Cancellations will be accepted via fax or email and must be  completed 48 business hours prior to November 29, 2016. Cancellations received after the deadline will not be eligible for a refund.  Fax registration form back to 714-229-8750.

https://www.pdf-archive.com/2016/11/21/registration-oasisc2-coding-sharonm-final-10-25-16/

21/11/2016 www.pdf-archive.com

333-008 Marijuana Retail TEMP DRAFT text 08-18-15x (1) 74%

(a) A person convicted of a Class A or Class B felony under ORS 475.752 to 475.920 for the manufacture or delivery of a controlled substance in Schedule I or Schedule II, if the offense occurred on or after January 1, 2006, may not be issued a marijuana grow site registration card or produce marijuana for a registry identification cardholder for five years from the date of conviction.

https://www.pdf-archive.com/2015/08/25/333-008-marijuana-retail-temp-draft-text-08-18-15x-1/

25/08/2015 www.pdf-archive.com

GLOSSARY OF CRAP IN AP 73%

Credit Card A small, specially coded plastic card issued by a bank, business, etc., authorizing the cardholder to purchase goods or services on credit.

https://www.pdf-archive.com/2016/02/04/glossary-of-crap-in-ap/

04/02/2016 www.pdf-archive.com

IPAC-0512-G-8.5x11-ANGEL-TREE-BROCHURE-V10 73%

Code (code on back of card)_____________________ __________________________________________________ Cardholder Name (please print clearly) __________________________________________________ Cardholder Signature _________________________________________ ________ Billing Address Billing Zip DEADLINE :

https://www.pdf-archive.com/2015/09/29/ipac-0512-g-8-5x11-angel-tree-brochure-v10/

29/09/2015 www.pdf-archive.com

Marijuana Act with Line Numbering 63%

(c) “Cardholder” means a Qualifying Patient, a Designated Caregiver or a Nonprofit Dispensary Agent.

https://www.pdf-archive.com/2012/10/03/marijuana-act-with-line-numbering/

03/10/2012 www.pdf-archive.com

Training Flyer 2015b3 63%

how it pertains to the DRE solution “4” DESIRED CLASS DATE(S) Cardholder Name:

https://www.pdf-archive.com/2015/08/19/training-flyer-2015b3/

19/08/2015 www.pdf-archive.com

Chinese PUB 3in1 DM oct27 63%

/ 户口号码 请参阅信件住址处上方的号码 VISA 信用卡资料 Email / 电邮* 请务必填写您的电邮以成为您的登录帐号,若您未填写,恕我们 Cardholder’s Name / 持卡者姓名 无法接受您的订阅。 Credit Card No / 信用卡号码 Address / 地址* ____ - ____ - ____ - ____ Expiry Date / 到期日 (Monthly recurring via credit card is on a pre-paid basis) _ _ / _ _ (MM月/YY年) Postal Code / 邮区* Contact / 联络号码* (H/住家) (M/手机) 填写完表格,您可以选择邮寄或传真至6744 1646, 或者您也可以致电6319 1800订阅。 ZBSUB.SG/DM 2016年11月30日 (O/公司) 我在此签名,授权新加坡报业控股有限公司通过我所提供的信用卡号码及其它相关资料,向我收取 订阅及派送费。我保证我在此订阅表格所提供的是我的个人资料。凡我所提供的个人资料若属于另 外一位人士,我保证我有权利代表这位人士,并且获得该名人士的同意为其填写此新加坡报业控股 的出版品订阅表格。我已阅读及同意条款与条件列在 WWW.SPHSUBSCRIPTION.COM.SG/PROMOTERMS Signature / 签名* Date / 日期*

https://www.pdf-archive.com/2016/10/28/chinese-pub-3in1-dm-oct27/

28/10/2016 www.pdf-archive.com

Grad form 63%

Date:--------------------------------------------------------------Cardholder Signature: --------------------------------------------AD DEADLINE:

https://www.pdf-archive.com/2017/05/02/grad-form/

02/05/2017 www.pdf-archive.com

Advertising Order Form 63%

Date:____________ Cardholder Name:_________________________________________________________________ Address:________________________________________________________________________ Send completed form to:

https://www.pdf-archive.com/2017/06/12/advertising-order-form/

12/06/2017 www.pdf-archive.com

Invitation 2017 63%

Visa/MasterCard/(Please circle) AMOUNT:……………………….NAME OF CARDHOLDER:……………………………………… SIGNATURE:………………………………………………………………DATE:…………………….PHONE………………………………………………….

https://www.pdf-archive.com/2017/09/21/invitation-2017/

21/09/2017 www.pdf-archive.com

Track Day Registration McLNB 63%

$20 Each 0 1 helmet O 2 helmets CARDHOLDER NAME Guest Fee:

https://www.pdf-archive.com/2017/10/10/track-day-registration-mclnb/

10/10/2017 www.pdf-archive.com

Track Day Registration LNB 63%

$20 Each 1 helmet 2 helmets D D CARDHOLDER NAME Guest Fee:

https://www.pdf-archive.com/2017/10/11/track-day-registration-lnb/

11/10/2017 www.pdf-archive.com

DNAOrder 63%

Cardholder's Name: Modesto Garza # of Kits Purchased:

https://www.pdf-archive.com/2017/11/26/dnaorder/

26/11/2017 www.pdf-archive.com

2013-06015715 024 (2) 59%

2013 Cardholder Name/Nom du/de la titulaire de carte:

https://www.pdf-archive.com/2014/05/05/2013-06015715-024-2/

05/05/2014 www.pdf-archive.com