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Please fill in any additional information by following the step-by-step guide on the left hand side of the preview document and click the "Next" button.
When you are done, click the "Get Document" button and you can download the document in Word or PDF format.
Please review the document carefully and make any final modifications to ensure that the details are correct before publication / distribution.
This is a template for Recurring Payment Authorization Form. By agreeing to this form, customers can give companies the authority to charge their credit card/ debit card without prior notice.
The customer certifies that he/she is a authorized user of this credit/Debit card and that he/she will not dispute the scheduled payments with the credit card company provided the transactions correspond to the terms indicated in this Payment Authorization Form.
Both the Company and Customers should read this form carefully.
The form outlines the frequency and reason for which the business is permitted to charge the debit /credit account of the customer .
The customer should provide the credit card / debit card details to the company and the form should be signed by the customer.