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Credit Card Authorization

This is a one time authorization for Advanced Hood Systems Service

to debit card listed below for kitchen hood work.

Card Type*

Visa

Master Card

Discover

Amex

Cardholder Name*

Card Number*

Expiration Date*

Security Code*

Zip Code

Amount to be charged*

Billing Address*

Email

Phone

Signature

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WE SERVICE

ORLANDO ,

FT. LAUDERDALE, MIAMI , NAPLES,

KEY WEST

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