place
6520 N. Powerline Road, Fort Lauderdale, FL 33309
Have Any Questions?
phone_in_talk
954.973.4700
Lotus Rep Login
New Customer Application
HOME
ABOUT
GALLERY
PRODUCTS
CONTACT
Download Current Price List (5/8/2023)
search
SEARCH BY:
SERIES
TILE COLLECTIONS
PerformX Series SPC
Stock Porcelain Slabs
COMING SOON
Top Sellers
WHILE SUPPLIES LAST
MATERIAL
PORCELAIN
Porcelain Slabs
WOOD LOOK PLANKS
SPC Vinyl Flooring
Sheet Tile – While Supplies Last
APPLICATION
FLOOR & WALL
WALL
Indoor / Outdoor
Porcelain Slabs
Online Purchase Order
SHOP BY:
Credit Card Authorization
Home
chevron_right
Credit Card Authorization
Please enable JavaScript in your browser to complete this form.
Customer Business Name:
*
Email address
*
Layout
Lotus Sales/Invoice Order Number
*
Amount to Charge
*
Do you have a credit card on file?
*
Select
Yes
No
Card Type
*
Visa
Mastercard
Amex
Last Four of card on file
*
Name of card holder
*
First
Last
Credit Card Number (VISA)
*
Credit Card Number (MC)
*
Credit Card Number (AMEX)
*
CVV
CVV (Front of card)
Layout
Card Expiration Month
*
Select
Jan (1)
Feb(2)
Mar(3)
April(4)
May(5)
June(6)
July(7)
Aug(8)
Sept(9)
Oct(10)
Nov(11)
Dec(12)
Card Expiration Year
*
Select
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
Billing Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Leave this card on file for future orders?
Select
Yes
No
Copy of ID and Credit Card (only required for non-corporate cards)
Click or drag a file to this area to upload.
Authorization
*
I authorize Lotus Business, LLC. to bill my credit card for the above order and amount. No Third Party credit cards accepted. All personal (non-corporate cards) must have copy of state issued ID and credit card attached above.
Authorized Signautre
*
Clear Signature
Submit
Menu