Credit Card Authorization                 Order #___________

Thanks for your recent order with our company.  Your order is now being processed.  However, to ensure against credit card fraud, please fill out this form and fax it along with a copy of the front and back of your credit card to: RefurbDepot at: 718-228-6948. As soon as we receive your faxed form along with the requested information, we will immediately proceed with your order processing. If you have any more questions, please call us at 1-800-660-4443 or e-mail us at customerservice@refurbdepot.com.

Customer Name: ____________________________________________

Credit Card Billing Address: __________________________________

City: ________________State: ____Zip: ________

Type of Credit Card: ÿ Visa    ÿ MasterCard    ÿ American Express    ÿ Discover

Name on Card: ________________________ Bank Name on Card: ______________

Credit Card #: _________________________Expiration Date: __________

I, ___________________________ am an authorized user of the above charge card (print full name).  I authorize Comtech (dba RefurbDepot) to charge a total of $_________to my charge card.

I authorize Comtech (dba RefurbDepot) to ship the goods I ordered, that are associated with the above referenced charge to:

Name: _____________________________________

Address: ____________________________________

City: _______________ State: _______ Zip: _________

The goods are being shipped to:

(Circle one):        my work                 as a gift to: __________             other: _________

Signature: __________________________

To complete your order, this form must be faxed to the above referenced number along with a copy of the front and back of your credit card. Your next credit card statement will reflect a charge from RefurbDepot. WARNING: Credit card fraud is a felony and we will aggressively prosecute anyone attempting to misuse a credit card number.  It is a felony to provide false information. Please double check to see that you filled out every field.  We cannot process your order if you left anything blank.   You must print your card number.  Comtech dba RefurbDepot, Brooklyn, NY. Thank you.