Airport CDJ Credit Card Deposit Form

I am placing a non-refundable deposit for an incoming vehicle.

I am aware of this charge and understand that a copy of my receipt will be provided to me.

I understand that a refund will be given only if Airport Chrysler Dodge Jeep fails to deliver the vehicle as discussed and agreed or if the vehicle does not arrive in proper condition for delivery (damage to vehicle).

I also understand that if there is a trade in involved in this transaction and the new vehicle takes over 30 days to arrive the trade in will have to be re-evaluated at the time of delivery.

I have read, understand and agree to these conditions and give Airport Chrysler Dodge Jeep LLC authorization to charge my credit card. *

Yes

Please charge my credit card in the amount of.....(if no amount is specified the standard amount is $1,000.00). *

Stock number of vehicle (last 6 digits of the VIN) *

Your Name (First - Last) *

Your email address *

Confirm email address *

Credit Card Number *

Expiration Date *

Security Code - 3 digits - 4 digits if Amex *

Billing Address *

City *

State *

Billing Zip Code *

Best phone number to contact you *

Driver's License Number *

Issuing State *