• Mon-Fri, 9am-5pm (PST)
  • 21541 Nordhoff St Unit C, Chatsworth, CA 91311
  • 1-818-609-9299

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    I hereby authorize Audionics System, Inc. to keep my Credit Card on file to process against Purchase Orders that I may place with Crux Interfacing Solutions.
    Type of credit card: (required) VISAAMEXMASTER CARDDISCOVER
    Credit Card Number:
    Expiration Date (Month/Year):
    CVV Security Code:
    Customer (Store) Name:
    Card Holder Name(Exactly as it appears on card)
    Billing Address:
    City:
    State:
    ZIP Code:
    Shipping Address:
    City:
    State:
    ZIP Code:
    Phone:
    Your Email (required)
    Fax:
    Federal Tax ID #:
    A COPY OF THE RESELLER PERMIT IS REQUIRED. PLEASE FAX IT TOGETHER.

    WHEN/IF YOUR CREDIT CARD IS EXPIRED OR YOU HAVE A NEW CREDIT CARD; YOU MUST CONTACT US TO KEEP THE RECORD CURRENT.

    PLEASE FAX THE COMPLETED FORM.
    Fax Number: 818-996-8188