CREDIT CARD AUTHORIZATION FORM

I agree to the terms and conditions noted in the Solvent Direct Purchase Agreement. I authorize use of my credit card for any and all charges accrued by me while purchasing from Solvent Direct. Since I may not be available when the delivery is made or the order is picked up, I agree that my signature below will act as a legal and binding signature for all purchases from Solvent Direct in my name or any employee of our company listed above with Solvent Direct.

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Solvent Direct must be notified immediately in writing if there are any changes in procedures in regards to the credit card on file or to authorized personnel lists. Failure to notify Solvent Direct of changes in procedure or authorized renters within your organization will not relieve you of financial responsibility for payment of rentals authorized as outlined above.