Credit Card Authorization Credit Card Authorization Form 10501 NW 50th StreetSuite No 102Sunrise, FL 33351(954) 541-5163orders@parklandcollection.com I, from , hereby authorize Parkland Collection LLC to charge my credit card account for purchases and incidental shipping charges or charges back billed to Parkland Collection. I authorize Parkland Collection to keep this card on file for all future purchases or order related incidentals mentioned above. visa Master Card American Express Discover Name On Credit Card Credit Card Number Expiration Date: 3-Digit VID Code: Credit Card Authorization Form Street: City: State: Zip: Telephone: Cardholder-sign Date: Your completion of this authorization form helps us protect you, our valued customer, from credit card fraud. Parkland Collection will keep all information entered on this form strictly confident