Ultimate Toys, Inc. - Credit Card Authorization

Amount of Charge*

USD

Cardholder Email*
Cardholder Phone*

Area CodePhone Number
Billing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Reply To Email
Charge Category*

Sprinter BalanceParts/ServiceShipping
I hereby authorize Ultimate Toys, Inc. to charge my credit card listed above on the specified date for the specified amount. I hereby acknowledge this is a non-refundable charge toward the purchase of an Ultimate Toys vehicle and/or related parts and/or service from Ultimate Toys, Inc.

I also understand there will be an additional convenience fee of 4% of the "Amount of Charge."
Cardholder Signature*

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Date*

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Date
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