Credit Card Authorization Form

When an order need to be shipped to an address different from the billing address or when an international credit card is used, we need to obtain your authorization.  You can either add the second address as an authorized alternate shipping address to your credit card account or complete the form below.

Instructions
  1. Complete the form online and type all billing and shipping information in the blanks below, or print the form and complete the blanks legibly with a dark pen.
  2. Print the entire form and sign with the credit card holder's signature on the line indicated.
  3. Include a photocopy of the front and back of the signed credit card, and Drivers License.
  4. FAX (1-801-349-2533) or scan and email the completed form and the photocopies of the credit card to complete your order.
 

Credit Card Authorization Form
  I, , hereby authorize R/C Planet to charge my credit card account in the amount of $   ( including / add shipping)

  VISA

 MasterCard American Express
Credit Card Number: 
Expiration Date:  /            VID Code: 

Credit Card Billing Address:

Street: 
               
City:      State: 
Zip Code:  -
Telephone:  () -

Country: (if not US)  

Requested Shipping Address:

Street: 
               
City:      State: 
Zip Code:  -
Telephone:  () -

Country: (if not US)  
As the credit card holder, I hereby authorize receipt of merchandise at the shipping address above.
__________________________________ ____/____/______
Cardholder's Signature Date

(Optional) As the credit card holder, I also authorize R/C Planet to charge my credit card for future purchases verbally approved by me.
     Authorization Valid Until: /         Initials Here:

Please Highlight and Print This Form

Your completion of this authorization form helps us to protect you, our valued customers, from credit card fraud.  All information entered on this form will be kept strictly confidential by R/C Planet.