Transfer My Timeshare
 
AUTHORIZATION TO CHARGE CREDIT CARD
-----------------------------------
 
Cardholder hereby authorizes the immediate charge to their credit card as
set forth below. Upon receipt of the funds from the credit card company,
the funds shall constitute the designated deposit required under the
purchase agreement and said deposit shall be held by Transfer My Timeshare
as escrow holder in accordance with the terms of the purchase agreement.
Refund of the deposit amount will be subject to the terms of the purchase agreement.
 
 
 
________________________________________________________________________
Full Name (as it appears on the credit card)
 

Credit Card Number:_____________________________________________________
(Type or print legibly)
 
Expiration Date: _______________________________________________________
 
Zip Code of Cardmember: ________________________________________________
 
Amount of Charge Authorized: $__________________________________________
 
 
 
CARDMEMBER ACKNOWLEDGES RECEIPT OF GOODS AND/OR SERVICES IN THE AMOUNT OF THE
TOTAL SHOWN HEREON AND AGREES TO PERFORM THE OBLIGATIONS SET FORTH BY THE
CARDMEMBER'S AGREEMENT WITH THE CREDIT CARD ISSUER.
 
 
 
________________________________________________________________________
Signature of Cardmember
 

________________________________________________________________________
Printed Name of Cardmember
 

________________________________________________________________________
Date of Signature of Cardmember
 
 
 

Please submit completed form to:
 
Escrow Holder:
Transfer My Timeshare, LLC
383 Central Ave. Suite 275
Dover, NH 03820

Phone: 877-216-4940
 
Fax: 603-516-0665