Your Company Name and / or Individual Authorized:

Type of Card: _______________ (Visa or MasterCard)

Card #: ____________ ___________ ____________ ____________

Exp. Date ______________ CVN# _______

Billing Address: _______________________________

Phone Number: _______________________

Email: ________________________________

This form authorizes Transitions Home Staging and Redesign to charge you / your Company’s Credit Card for the services provided and / or the rental of home staging Goods, as outlined in the Terms & Conditions.

Please select one of the following payment options:

Once – please bill my credit card for the following amount: $________

Monthly – please bill my credit card once per month for the amount of serviceprovided each month for all contracts with Transitions Home Staging and Redesign.Applicant agrees that all information provided is accurate and complete.Applicant also acknowledges that if any charges are declined or chargebacks are claimed against any outstanding invoiced amount, services and /or Goods may be ceased & removed immediately. Disputes to amounts orchanges in the status of this card should immediately be sent toKathie@Transitions-HomeStaging.com.

The undersigned is the duly authorized representative of the companylisted above or is the individual authorized to sign for this card.

Signature: ________________________________________________

Date: ____/_____/___________