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Dealer Name:
Dealership Address:
(all orders will be shipped to this address only)
Phone Number:
Name on the credit card Account:
Credit Card Billing Address:
Visa
Mastercard
American Express
Account Number:
Exp:
Optional Second Credit Card
Visa
Mastercard
American Express
Account Number:
Exp:
Card Holder Signature:
I authorize Sudco International Corp. to charge the above credit card(s) for purchases and
shipments to the above motorcycle shop/ dealership.
Complete form and return to:
Sudco International Corp, 2410 S Sequoia, COMPTON, CA 90220
Tel: 310-637-8330 FAX: 310-637-8331
Credit Card Authorization
Should you prefer COD, please check here.