CREDIT CARD AUTHORIZATION FORM

  To (Seller):
  Access Music / accesshiphop.com
  1537 Garnet Avenue, San Diego, CA, 92109, USA
  Fax No. 209-755-5968

  Buyer Name: _____________________________

  Order ID No.: _______________________ (from confirmation email)

  Order Amount: $ _____________

  [ ] VISA   [ ] MasterCard   [ ] American Express   [ ] Discover

  Credit Card No: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

  Expiration Date (mo./yr.): ________________

  Bank that issued the credit card: _____________________________ 

  Phone number for the credit card: _____________________________ 

  By signing below I testify that I am the credit card holder for
  the above referenced credit card.

  I authorize Access Music / accesshiphop.com to charge my credit 
  card for the order amount shown above including shipping.

  I agree to pay Access Music / accesshiphop.com the above total 
  amount according to the card issuer agreement.

  Print Your Name: ___________________________________



  Credit Card Holder Signature: _________________________________

  Date: _______________________

  Attachments:
  (1) A copy of your credit card (front and back).
  (2) A picture ID showing the same name as on the credit card.