Credit Card Authorization Form

I, hereby, authorize J & P International LLC on behalf of Thamel Dot Com Pvt Ltd. to process
a charge on my Credit Card, for the amount I've been credited as per their invoice for my order.
I certify that I will use a genuine Credit Card, which I am authorized to charge. I enclose with
this letter a Credit Card and Photo ID that I hold as a measure to certify my authenticity.

Card Details

Invoice / Gift Order Number: __________________

Type: VISA [    ]  / Master Card [    ]  / AMEX [    ]

Name on Card: __________________________________________________________

Card Number: ______________________________ Expiry: ________ / _____________
                                                                                                 (Month / Year)

Amount: _____________ In words ( __________________________________________________ )

Signature on the Card: ___________________________

Other Details

Street: ________________________________

City: __________________________ State/Province: _______________

Country: _________________________ Zip/Postal Code: ___________

Telephone:_________________  Email: _________________________