Are you paying for your son’s or daughter’s books this fall semester? What if they need to return, exchange or buy additional books once you have returned home? We can make it work for you without a hassle. This form enables your son or
daughter to take care of returns and exchanges or buy additional books on your credit card, with your permission. Once you have authorized them, they will not need your card as long as they have a valid picture ID. We will then be able to debit or credit your card with their signature. You can authorize them to buy and return books, school supplies, clothing, gift items and more, or you can restrict usage of the account by dollar amount, product or time limit…whatever works best for you!
Credit Card Authorization Form
You can fill out this form and bring it with you when you pick up your books, or fax it to:
(610)-692-4501
Name on Card: _____________________________________
Address ___________________________________________
___________________________________________________
Phone # ___________________________________________
Credit Card Type:
Please circle one: VISA MasterCard Discover AMEX
Card # : ___________________________ Exp Date ______
Student’s Name: ____________________________________
I grant my son/daughter specific authorization and permission to make additional purchases, exchanges and returns using the credit card number listed above. I authorize Lieberman’s Dynamic Bookstore to charge this card for such purchases and authorize my son/daughter to sign on my behalf.
▢ Please use this card to PREPAY for my son’s or daughter’s book reservation
▢ Please restrict credit card charges to textbooks and school supplies
PLEASE INCLUDE A LIST OF ANY OTHER LIMITATIONS YOU WANT TO PUT ON THIS AUTHORIZATION (i.e., Time limit, dollar amount limit, number of books or specific books or classes needed)
Print Name: __________________________________ Date: ___________
Signed: ______________________________________
