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CREDIT CARD AUTHORIZATION FORM
 
I , HEREBY AUTHORIZE MILLENIUM AIR PARTS
TO DEBIT IN MY CREDIT CARD NUMBER
EXPIRATION DATE / CODE IN AMOUNT OF U$
BILLING ADDRESS:
CITY STATE ZIP
TAX ID NUMBER: PHONE
Email:
 
PS: PLEASE SEND A COPY OF YOUR DRIVER LICENSE AND CREDIT CARD (FRONT AND BACK)
Upload DRIVER LICENSE  
Upload CREDIT CARD  
 
 
     
   
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Address:
20871 Johnson Street
Pembroke Pines, FL 33029

Phone: (305) 827 5600
EMAIL: sales@allparts.us
flavia@milleniumair.com

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