Credit Card Authorization Form
Skybook Sportsbook

This form is an application for a credit card deposit*. Make sure all the information requested below is completed. Remember to sign and date the authorization form in the assigned space at the bottom of the page. Submit the following documentation, along with this form:

· A clear photocopy of the front and back of your credit card.
· A clear photocopy of the front side of your driver’s license (or state issued ID).

Fax the form and additional information to 1-800-327-7081. You may also email the documentation: scan the information and send it to support@skybook.com.

Your Skybook account: ______________________

Your name (as it appears on your credit card): _____________________________________________

Credit card number: ______________________________________ Exp Date: ______/______/________

Billing address: ________________________________________________________________________

City: ____________________State:__________________: Zip: _______________

Phone number : (____) ________-__________ Fax: (____) _______-___________

Email: __________________________________

IMPORTANT

By submitting this form, signed and dated, along with additional information, I__________________________________________________authorize Skybook to charge my credit
card for all deposits made to my account. I acknowledge that I am the person who opened this account, entered into all transactions, and deposited funds using the above credit card. I will honor ALL deposits to my Skybook account—appearing on my billing statement as Skybook.com—and will pay them in full. I further agree that I will not dispute the charges.

Card Holder’s Signature: __________________________________ Today’s date: _____ /_____ /_____

* This form will act as a permanent signature on file for any future credit card transactions.