Credit Card Authorization - Elite Used Auto Parts

Customers that need to fill out a Credit Card Authorization form for Elite Used Auto Parts should use the form below. Complete all the required fields below and click submit to immediately send your credit card authorization form to Elite Used Auto Parts. You may also download a form here & fax back to 631-226-1056

Authorization to Charge Credit Card

For your security, Elite Auto Parts requires this authorization form to be completed in order to charge your credit card.

Credit Card #

Expiration Date

CVV #

Company Name

Name On The Card

Billing Address

Billing Phone

Fax Number

Please upload a copy of the credit card and Copy of Photo ID with SIGNATURE of the Cardholder (e.g. Driver License, Passport)

.

IT MUST BE CLEAR ENOUGH FOR US TO AUTHENTICATE YOUR SIGNATURE.

Upload Documents

*All returns or cancellations subject to 20% return fee plus shipping charges.

I confirm that I am authorized to use this credit card for a purchase from Elite Auto Parts Inc.

I agree that I will be Responsible for all payments via this credit card.

Signature (CC Owner)

Date

Amount

Parts

Shipping

Guarantee

Total

Parts Ordered

Delivery Name

Delivery Address

Delivery Phone

Contact Name

CALL 631-226-1003 IF YOU NEED ANY INFO.

Credit Card Authorization – Elite Used Auto Parts

Authorization to Charge Credit Card

For your security, Elite Auto Parts requires this authorization form to be completed in order to charge your credit card.

Please upload a copy of the credit card and Copy of Photo ID with SIGNATURE of the Cardholder (e.g. Driver License, Passport)

You may also download a form & fax back to 631-226-1056

Simple modal box