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calRecycla0*6 <br /> CREDIT CARD AUTHORIZATION <br /> INSTRUCTIONS: <br /> 1. For conducting transactions using VISA or MasterCard only. No other cards are accepted. <br /> 2. Complete all cardholder information. <br /> 3. If you have any questions,please call the Accounting office at(916) 341-6185. <br /> 4. Mail this form to: <br /> ATTN: Cashier <br /> Department of Resources Recycling and Recovery <br /> 10011 Street/P.O. Box 4025 <br /> Sacramento, CA 95812-4025 <br /> CARDHOLDER DETAIL <br /> Check One: O VISA O MASTERCARD <br /> Credit Card Number(16 digits): <br /> Security <br /> Credit Card Expiration(MM/YY): Code <br /> Payment Amount: $ <br /> Signature of Cardholder <br /> (Name appearing on Credit Card): <br /> Name of Cardholder(type or print): <br /> Company: <br /> Address: <br /> City: State: Zip: <br /> Email: <br /> PAYMENT DETAIL <br /> For Payment of(attach documentation): <br /> Invoice#(if applicable): <br /> REQUEST RECEIPT <br /> Would you like us to send you a receipt? Select option below: <br /> 0 Email <br /> '0MINAL MaM ON 100%PDSTUMUMER WMEM,PROMSED MIORINE FREE PAPER <br />