Credit Card Authorisation From

Card Holder Name

Company Name

Address

Contry

State/Region/Province

Postal / Zip Code

City

Phone

Card Type

Visa MasterCard Amex Discover

Visa Card Number

MasterCard Number

Amex Card Number

Discover Card Number

CVV

Expiration Month

Amount to Authorize

Description of Purchase/Service

Authorization Date

I hereby authorize Global SATELLITE GROUP to charge my credit card for the amount listed above. I understand this transaction is non-refundable and agree to the terms and conditions.