711 Lake Street Kent, Ohio 44240 USA Credit Fax: 330. 676.6266 Credit Card Authorization Form (Please Print) Date: / / 4.6 / I authorize KENT Demolition Tools to charge (in USD) $ 3,76 K9010 Oa. .83 MasterCard Visa ____k_— 1/2 4 3/5PHyg .3B9a JAL-z - (usually found on back of Card) --rgt ,F.ke/ kreps