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  • Credit Card Authorization Form

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    joe
    29 views1 page
    If you would like to enjoy the convenience of recurring automatic payments, simply complete Credit Card Authorization below and sign the form. Upon approval, we’ll automatically bill your credit card the amount indicated and your total payments will appear on your monthly invoice.

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    If you would like to enjoy the convenience of recurring automatic payments, simply complete Credit Card Authorization below and sign the form. Upon approval, we’ll automatically bill your credit card the amount indicated and your total payments will appear on your monthly invoice.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    29 views1 page

    Credit Card Authorization Form

    Uploaded by

    joe
    If you would like to enjoy the convenience of recurring automatic payments, simply complete Credit Card Authorization below and sign the form. Upon approval, we’ll automatically bill your credit card the amount indicated and your total payments will appear on your monthly invoice.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    Credit Card on File Authorization Form

    Ifyouwouldliketoenjoytheconvenienceofrecurringautomaticpayments,simplycompleteCreditCard
    Authorizationbelowandsigntheform.Uponapproval,wellautomaticallybillyourcreditcardtheamount
    indicatedandyourtotalpaymentswillappearonyourmonthlyinvoice.

    Customer/Company:___________________________________________________________

    ContactName:_______________________________________________________________

    AccountNumber:_____________________________________________________________

    EmailAddress:_______________________________________________________________

    PhoneNumber:
    ()
    Ext:________________

    IherebyauthorizevzPROConsulting,Inc.toautomaticallybillthecardlistedbelowasspecified.

    __________________________@$____________/Lead

    __________________________@$____________/Lead

    __________________________@$____________/Lead

    __________________________@$____________/Lead

    __________________________@$____________/Lead

    Pleasefilloutthedetailsasindicatedbelow:

    CardHoldersName:______________________________________________________________

    CardNumber:________________________________EXP________/________

    I,theundersigned,amanauthorizedsignerofthecreditcarddetailedabove.IauthorizevzPROConsulting,Inc.tousethe
    creditcardinformationabovetopayanyinvoicesformyaccount.Iwillbeprovidedacopyofmyreceiptbyeitherstandardmail
    orelectronicallyatmydiscretion.

    Signature:___________________________________TodaysDate:___/___/____

    Pleasechooseallofthefollowingoptionsthatapply:
    Iwouldliketoreceivereceiptsofmypayments
    []Electronically
    []viaStandardMail

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