166 Station Rd., Bernville, PA  19506 / Phone: 610-621-5290/ Fax: 610-621-5299
A Nationwide Community non Profit 501(c)(3) Organization (Non Profit Tax ID# 20-0285993) - Donations are tax deductible.

                                                           Credit Card Authorization (Confidential Information)

I hereby authorize Another Chance 4 Horses, Inc., located in Pennsylvania to bill the following credit card number in the amount of $              

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