CREDIT CARD AUTHORIZATION

Type of Card in Use (check one)
 Visa
 MasterCard

Account Number: ______________________________________________

Expiration Date: _______/______
Month/ year

V-Code: __ __ __
(Last 3 digits of security numbers located on signature panel)

Billing address for cardholder:

______________________________________________________
Street Address City State Zip


It is agreed and understood that credit card use will be restricted to charges for services performed. Once performed, services cannot be cancelled.


______________________________________________________
Print Cardholder’s Name


______________________________________________________
Cardholder’s Signature


Special Notice:
This form will be destroyed at the end of the loan process.
 

Vision Mortgage Company, Ltd.
In the Lincoln Center Building at Callaghan and I.H. 10 West
7800 I.H. 10 West, Suite 112 ~ San Antonio, Texas 78230-4768 ~ U.S.A.
Office: 210.348.0077 ~ Fax: 210.348.0542 ~ Cellular: 210.823.LOAN (5626)
Texas Mortgage Broker License Number 90

E-Mail: