SKYTOWER SPORTSBOOK and CASINO
This is confirmation of your request for payment by your Visa/Master card.
Your signature below constitutes your agreement to pay the amount below, and authorizes Skytower Sportsbook and Casino to obtain credit approval from said credit card company.
You must sign this agreement as well as the Credit card authorization form below
I, _____________________________ hereby authorize Skytower Sportsbook and Casino to charge my credit card (below) the stated amount. I also understand the authorization will show up on my credit card as DMS billing.com, SFPAY.CO.UK, ttsupport.com. Furthermore it is understood this payment is irrevocable.
City: ________________________ State __________ & Zip:_________________
Phone Number: _____________________ User ID# ________________________
Deposit Date (s): ____________________________________
Credit Card #: _____________________________ Exp. Date: _______________
CVV code 3 or 4 digit number on the back of your card: _____________________
Purchaser Sign here: X_______________________________________________
Please fax to 1-720-293-4507
Cardholder acknowledges receipt of goods/services in the amount (US DOLLARS) of the total shown
Herein and agrees to perform the conditions set forth in their cardholders agreement with the user.
*Please send a COPY of your driver license and of your credit card with your fax approval document.