Old Father Time Credit Card Authorization Form

Name (as it appears on your card statement)
Address             (as it appears on your card statement)
Add'l. Address
City State/Province Postal Code
EMail Address (we'll contact you by email)
Phone Number (Your bank may call you to verify)

Card Account Number (Your card account number)

Expiration Date     CCID (3 Digit Code)

Amount to be Charged in payment for OFT Order #

I, the undersigned, agree to allow OLD FATHER TIME to electronically charge my card in the amount shown above, on or after the date shown. I am providing a copy of this transaction to Old Father Time by mail or email. Old Father Time may (if requested), provide it to the card processing bank for verification.


Signature
                                                                                                                 Date
The use of credit or debit cards carries a 4.77% "Convenience Fee" which is added to the total amount due. This fee can be avoided by using our E-Check Authorization Form instead.
(The information on this form is not sent through the internet, it is only indended for PRINT.) Please Complete this Form on your screen, then print it and send by fax 1-(888) 668-1150, postal mail, or email
attachment to watchmakers@oldfathertime.com