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Credit Card Authorization

I,

hereby authorize Ripe VIP Inc. to charge my credit card below for agreed upon purchases. I understand this information will be saved on file for future transactions. I understand there is a 3% terminal fee when making payments via credit card.

Type of Card:

VisaMasterCardAMEX

Credit Card Number:

Expiration Date:

Security Code:

Name of Cardholder:

Credit Card Billing Address:

Cardholder Signature:

By signing this, I acknowledge and assume responsibility for the charges to my account and agree to honour the payment terms of projects and services.

Company Name:

Date: