Authorization to Charge Credit Card Form
I (sign) _______________________ hereby authorize Jeanne Eubanks of Uey’s Homeraised Puppies to charge my credit card in the amount of $_____________. This purchase is nonrefundable. The buyer agrees that he or she is fully responsible for the health of this puppy once the puppy is in their possession. The breeder is only responsible for problems that are genetic in nature or are the direct result of improper care given by the breeder.
The buyer, by signing this agrees that it is unfair to say that if the puppy dies for a reason that is no fault of the breeder once the puppy is in the buyer’s hands, this is not fair to dispute the credit card charge and make the breeder pay for the puppy. The breeder would of course, be responsible for problems associated with the puppies health that were her fault. (A 3% charge applies to all credit card transactions {5% for Canadian tranactions}.)
Signed _________________________
Printed name that is on credit card _______________________________________
The 800 number on the back of your credit card for address verification
_______________________.
Credit card number________________________________ Expiration date________________
Address ____________________________________________________________
City______________________State_______________Zip Code ____________
Phone Number ___________________





STATE OF _____________
COUNTY OF ___________
Before me, the undersigned authority personally appeared __________________, who is personally known to me or who has shown ________________________ as identification, and is shown to be the person described herein.
____________________________
Notary Public ____________________________
Printed Name of Notary (Seal)




_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Authorization to Charge Credit Card I (sign) _______________________ hereby authorize Jeanne Eubanks of Uey’s Homeraised Puppies to charge my credit card in the amount of $_____________. This charge is for a deposit on a puppy. No refunds will be given if the buyer decides to back out of the deal. The buyer, by assigning this contract, fully understands that payments are nonrefundable unless something happens to the puppy while it is in the possession of the breeder. (For instance, the puppy dies while in the possession of the breeder.)
Signed _________________________
Printed name that is on credit card _______________________________________
Number of card______________________________Expiration Date ____________________________
The 800 number on the back of your credit card for address verification
_______________________.
Address ____________________________________________________________
City______________________State_______________Zip Code ____________
Phone Number ___________________ The buyer, by signing this agrees that it is unfair to say that if the puppy dies for a reason that is no fault of the breeder once the puppy is in the buyer’s hands, this is not fair to dispute the credit card charge and make the breeder pay for the puppy. The breeder would of course, be responsible for problems associated with the puppies health that were her fault. A 3% charge applies to all credit card transactions{5% for Canadian transactions}.)





STATE OF _____________
COUNTY OF ___________
Before me, the undersigned authority personally appeared __________________, who is personally known to me or who has shown ________________________ as identification, and is shown to be the person described herein.
____________________________
Notary Public ____________________________
Printed Name of Notary (Seal)