TOWN Credit Card Authorization Form

Community Development Department

Of 6401 E Lincoln Drive
Paradise Valley, AZ 85253
PARADISE VALLEY (480) 348-3692

CREDIT CARD AUTHORIZATION FORM

I, _____________________, hereby authorize the Town of Paradise Valley Community

Development Department to charge my credit/debit card in the amount of $ _________

for building permits.

Name as it appears on the credit card_________________________________________

Credit Card Zip Code ________________ Contact Phone#_______________________

Visa or Mastercard ONLY. (3% fee applies) American Express is NOT accepted.

☐ Visa ☐ Mastercard

Credit Card #:_____-_____-_____-_____ 3-digit CCV Code:____ Exp. Date: ___/___

Updated July 2023