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Parker Outdoor, Inc. <br /> At Parker Outdoor, Inc., we offer automatic payment options for your convenience. If you would like to <br /> have your monthly invoices set up for automatic credit card payments, please fill out the form below and <br /> email(Kerry@parkeroutdoorinc.com)or fax(509-470-8427) to us as soon as possible. If you would like <br /> to do a Bank Draft/ACH Debit please contact us for the information you will need to set up the payment <br /> through your financial institution. Of course, you also have the option to mail your payment directly to <br /> our office address(on your invoice)each month. If you have any questions or concerns regarding your <br /> payment options please contact our office. Thank you and welcome to the Parker Outdoor Inc.family! <br /> CREDIT CARD AUTHORIZATION <br /> I authorize by my signature any and all valid charges made on my credit card by Parker Outdoor, Inc. <br /> Choose one: <br /> V I understand my credit card will be billed monthly for services rendered and so authorize said <br /> billing. I understand that charges declined by the credit card issuer will constitute grounds for cancellation <br /> of contract and that all monthly charges incurred will be subject to collection procedures. This <br /> authorization will continue until revoked in writing. <br /> 1 authorize my credit card to be billed for a one-time charge or in lieu of a deposit. No additional <br /> billings are authorized. I understand that charges declined by the credit card issuer will constitute grounds <br /> for cancellation of contract and that all monthly charges incurred will be subject to collection procedures. <br /> This authorization will continue until revoked in writing. <br /> Please complete all the following information. Your account cannot be processed if incomplete. <br /> Check type of Credit Card: MC 1.VISA ' AMEX (check one) <br /> CC Number: 4715 2912 0030 5012 <br /> Exp Date: 09/19 CVV Code(on back): 535 <br /> Name of Card Holder: Sabina Popa City of Everett WA (As appears on the card) <br /> Address: 3201 Smith Ave. Suite 215,Everett WA 98201 <br /> City Everett, State WA Zip 98201 (As appears on the statement) <br /> Signature of Credit Card Holder Page 4 of 4 <br />