MERRICK TACKLE
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POLICY PAGES
Merrick Tackle Center Inc.
Merrick Tackle Center
7349 Route 28
Shandaken, NY 12480
Phone (845) 688-2216
Fax (845) 688-2329
CHARGE CARD AUTHORIZATION FOR DROP SHIPMENTS
In order for us to process a drop shipment to a customer, other than an account holder, using the account holders card,
all the following information must be filled out:
Ship To: (This must be a physical address - No P.O Boxes)
Name:____________________________________________________________________________
Street:____________________________________________________________________________
City, State & Zip Code:_______________________________________________________________
I authorize the use of my credit card to purchase the following items and to ship these items to my customer, at
the above address:
(specify items)
Card Number:______________________________________________________________________
Expiration Date:___________________________
Card Holder's Signature:______________________________________________________________
Please also Print Your Name:__________________________________________________________
By my signature, I agree to payment with my card, to Merrick Tackle Center for all items listed above.
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