Recurring Credit Card Authorization Form

C. Bennett Building Supply, Inc.

1700 West Terra Lane
O’ Fallon, MO 63366
Phone: 636.379.9886 Fax: 636.379.9863

I hereby authorize C. Bennett Building Supply, Inc., to charge my credit card provided herein.

This authorization remains in effect for this order and all future orders from said company listed above until C. Bennett Building Supply, Inc., receives written notice from me that this authorization is cancelled, or until C. Bennett Building Supply, Inc., notifies me in writing that this authorization is no longer valid. I certify that I am an authorized user of this credit card and that I will not dispute the payment(s) with my credit card company; so long as the transaction(s) corresponds to the terms indicated on this form.


C. Bennett Building Supply, Inc., will keep all information entered on this form strictly confidential.
You can also download a copy of the form here