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Payment Authorization Form

Recurring Payments

Easily manage recurring payments with our Payment Authorization Form. Securely authorize transactions for hassle-free billing.

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Document Description

The Payment Authorization Form is a document that allows customers to schedule automatic payments to be charged to their debit or credit card. This form outlines the terms and conditions of the authorization and provides instructions for completing the form.


The importance of this document lies in its ability to streamline the payment process for both the customer and the account job company. By authorizing regularly scheduled charges, customers can ensure that their payments are made on time and without the need for manual intervention. This not only saves time and effort but also helps to avoid late payment fees and potential disruptions to services.


The document is divided into several sections, each serving a specific purpose. The first section provides a brief introduction to the form and explains its purpose. It also informs the customer that they will be charged each billing period for the total amount due and that a receipt will be emailed to them.


The next section instructs the customer to complete the necessary information, including their billing address, phone number, city, state, email, and debit/credit card details. The customer is also asked to indicate the frequency of the payments (monthly, bi-monthly, or annually).


Following this, the customer is required to provide their cardholder name, expiration date, and CVV number. They are then asked to sign and date the form, indicating their authorization for the account job company to charge their credit/debit card.


The final section of the document contains important information regarding the execution of payments on weekends or holidays, the cancellation of the authorization, and the customer's responsibility to notify the business of any changes in their account information. It also includes a certification that the customer is an authorized user of the card and will not dispute the scheduled payments.


Overall, the Payment Authorization Form is a crucial document for both customers and the account job company. It ensures a smooth and efficient payment process while providing clear instructions and guidelines for completing the form.

How to use this document?

1. Provide your billing address, phone number, city, state, and email in the designated fields.

2. Select the type of card you will be using for the payment (Visa, Mastercard, or Amex).

3. Enter the cardholder name, expiration date, and CVV number.

4. Sign and date the form to authorize the account job company to charge your credit/debit card.

5. Note that if the payment dates fall on a weekend or holiday, the payments may be executed on the next business day.

6. To cancel the authorization or make changes to your account information, notify the business in writing at least 10 days prior to the next billing date.

7. Certify that you are an authorized user of the card and agree not to dispute the scheduled payments.

8. Be aware that in the event of non-sufficient funds (NSF), the account job company may attempt to process the charge again within 30 days, and an additional 15% charge will be applied as a penalty for each attempt returned NSF.

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