WINDOWS  CASINO
Credit Card Charge Authorization Form

Print out this form and fax it to Windows Casino, along with a photocopy 
of a valid official picture identification card (driver's license, passport,
etc.), your credit card billing statement and a utility bill (phone, electric, 
gas, etc.) with your name and address as it appears on your credit card 
billing statement and your Windows Casino account. 
______________________________________________________________________________

This form confirms your request for payment by Visa/MasterCard.

Your signature below constitutes your agreement to pay the amount 
specified below, and authorizes Windows Casino to obtain credit approval 
from said credit card company.

You must sign this agreement as well as the credit card authorization 
form below.

I,__________________________________, hereby authorize Windows Casino to 
charge my credit card account as  "CompECash"  I affirm that I am at
least 18 years old and that I am legally authorized to use the credit card 
account number specified below.  Furthermore, I understand and agree that 
the charges specified below are irrevocable and may not be charged-back at
any time in the future.

SIGNATURE: x______________________________________.  

Address: ___________________________________________________________.

Phone #: _____________________.  City: _____________________________.

Date: _________________    State: _________ Zip/Postal Code: _______.

Authorization for Deposits to Windows Casino Account

Per my request(s) through their online credit card processing system, I 
hereby authorize Windows Casino to charge  up to $____________ per month
on the following credit card account

Credit Card #: __________________________________.

Expiration Date: _____________

SIGNATURE: x_____________________________________________.


Cardholder acknowledges receipt of goods/ services in the amount 
( US Dollars) of the total shown herein and agrees to perform the
conditions set forth in their cardholders agreement with the user.

_________________________________________________________________



Notary Acknowledgment

State of ________________

County of ______________

On __________________________, before me, the undersigned, a 
Notary Public in and for said County and State personally appeared
 ________________________________, personally known to me (or proved
to me on the basis of satisfactory evidence) to be the person whose 
name is subscribed to the within Credit Card Authorization Form and 
acknowledged to me that said person executed it.

Witness My Hand and Official Seal

______________________________________
Notary Public in and for said County and State

My Commission expires ___________________


PLEASE SIGN THIS FORM IN BOTH PLACES ABOVE IN FRONT OF A 
NOTARY PUBLIC.  

FAX SIGNED FORM & LEGIBLE PHOTOCOPIES OF PHOTO 
IDENTIFICATION CARD, CREDIT CARD STATEMENT & UTILITY BILL. 

Windows Casino fax:(509)562-1275