Bingo Knights.com Credit Card Authorization Form

Date:_______________________________________________.

Name:______________________________________________.

Card number:________________________________________.

Expiration Date:_______________________________________.

I hereby authorize online purchases to be made with the above card, and agree to pay for my deposits as stated on the issue agreement for the respective card. By signing this form, I acknowledge my purchases at www.bingoknights.com may show as VIBINGO or any of their alternate descriptors.

In order to comply with Visa and MasterCard regulations, I enclose a copy of both sides of the credit card mentioned above, a copy of any utility bill as well as a proof of ID stating my exact name, address and signature providing authorization for all my purchases at www.bingoknights.com.

I agree to the above terms and conditions as stated by bingoknights.com

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Customer’s Signature.