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Payment authorization

I, the customer named above, authorize Layaway US to check my card today for $0 — nothing is charged now — and then to charge my card:

• — payments of — every week, starting on my payday — and ending —.
• Total of all payments: — — the sticker price plus sales tax. Nothing more, ever.
• My order ships within 1–3 weeks after my final payment — free.
• I can cancel anytime — the fee is the lesser of 10% of what I’ve paid or $25; the rest refunds to my card within 14 days.
• You are never obligated to complete the payments, and a missed payment never creates a debt.
• Charges appear on my card statement as LAYAWAYUS*.
• A copy of this authorization will be emailed to you.