Billing Address Date: Name: - Morristown Partnership

Credit Card Release Form. Note: Morristown Partnership recommends lower denominations to insure the recipient will use the gift certificate in its entirety at any ...
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Billing  Address     ________  (indicate  with  X  if  same  as  mailing  address)  

Mailing  Address     Date:     __________________________________________     Name:  __________________________________________     Street:  __________________________________________     Town:  _________________  State:  ______  Zip:  ______     Phone:  (_________)_______________________________     Fax:   (_________)_______________________________     For  pick-­‐up:    __________________________________                (Mon.-­‐Friday,  9am-­‐5pm  only)

 

Date:     __________________________________________     Name:  __________________________________________     Street:  __________________________________________     Town:  _________________  State:  ______  Zip:  ______     Phone:  (_________)_______________________________     Fax:   (_________)_______________________________       Credit  Card  Release  Form   Note:  Morristown  Partnership  recommends  lower  denominations  to  insure  the  recipient  will  use  the  gift   certificate  in  its  entirety  at  any  one  location  as  opposed  to  receiving  a  credit  at  a  participating  business.                  Denomination                        Quantity            Total     $50.00       _____________     $_____________     $25.00       _____________     $_____________     $10.00       _____________     $_____________     $5.00       _____________     $_____________  

 

The  Morristown  Partnership  will  issue  and  charge  the  above  gift  certificate(s)  totaling  $____________________,       to  the  following  VISA  /  MasterCard  (only  cards  accepted,  circle  one)     Credit  Card  #:  _________________________________________________________________________________________________________     Security  Code  (CVV2#):  ____________________________________  Expiration  Date:  _____________________________________   I  understand  the  Morristown  Partnership  will  not  be  held  liable  for  the  loss  of  the  gift  certificate.         Signature                     Date   Thank  you  for  supporting  the  gift  certificate  program.