Authorized Person Pickup Form If you are a human and are seeing this field, please leave it blank. Fields marked with an * are requiredThank you for your order. To protect our customers, our policy requires that only the cardholder/self, can pick-up the order from our store with a valid State picture ID card and the original credit card used to place the order. This policy was accepted by you when you placed your order.If you are not able to come to our store in person and would like to send an authorized person to pick-up your order from our store, please complete and submit this secure form ASAP. We must have a complete form no later than the day before you send an authorized person to pick-up your order from our store.All information you provide on this form will be checked with the credit card issuer bank. Therefore we urge you to provide the most accurate information to help us to process your request as fast as we can.Note: If you do not remember any of the answers, please contact your credit card bank issuer before completing and submitting this form.Please complete the entire form. Fields marked with * (asterisk) are required. We will contact you if additional info is necessary.STEP 1: ORDER INFORMATIONCredit Card Info Exact Person's Name on Credit Card * Exact Company's Name on Credit Card Note: If both Person's and Company's Name are shown on the card, please list both. Credit Card Type * Please SelectVisaMasterCardAmerican ExpressDiscover Last 8 Digits of Credit Card Number * Expiration Month * Please Select01 January02 February03 March04 April05 May06 June07 July08 August09 September10 October11 November12 December Expiration Year * Please Select20202021202220232024202520262027202820292030 Security Code/CVV * Credit Card Bank Issuer Name (See back of the Credit Card) * Credit Card Bank Issuer Phone Number (See back of the Credit Card) * Name and phone number of Credit Card Issuer are written on the back of credit cards. Phone # the credit card bank issuer has for you on file * E-mail Address the credit card bank issuer has for you on file Billing Address Exact Street Address * City * State / Province * Zip / Post Code * Country * Please SelectUnited StatesCanada STEP 2: AUTHORIZED PERSON INFO Authorized Person's Full Name * Authorized Person's Phone Number * Relationship to you (Family, Friend, etc) * We will notify you by E-mail/Phone Once your Order is ready for Pickup. This form is transmitted using secure encryption.Thank you for your cooperation. The sooner we receive these answers, the faster we process your order.1 Day Banner (877) 587-4467