Request for Charging Credit/Debit Card

To: HD Head Office:
MF ID
MF Name
MF Area
Country
MF email

Please charge credit/debit card ending
Currency 

 Amount Cents  Invoice No. In respect of
.
.
.
.
.
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Comments

Payments by credit card over 12,000 per 12 months commencing on August 1st of each year will incur a 2% charge.