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By authorizing this transaction, customer agrees that merchant may convert this transaction into an Electronic Funds Transfer (EFT transaction or paper draft, and to debit this account for the amount of the transaction. Additionally, in the event this draft or EFT is returned unpaid, a service fee, as allowable by law, will be charged to this account via EFT or draft. In the event you choose to revoke this authorization, please do so by contacting the merchant directly. Please note that processing times may not allow for revocation of this authorization.

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Reference no	8ac7a49f900e761301900f4038917254
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Total Amount paid	$

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