Credit Card Authorization Form

Credit Card Authorization Form2018-07-06T14:05:18-08:00

We understand that from time-to-time it may be necessary to utilize the credit card of your business partner, associated, friend or family member, and we are OK with that. However, as a necessary security protocol, we need to obtain validation from the cardholder to complete the following information to include a copy of a government ID and credit card. Thank you for your cooperation to ensure safe and sustainable business practices.

The easiest way to upload photos of the front and back side of the credit card is with mobile phone, including filling out this from a mobile device. Once the items are uploaded, we recommend deleting them from your phone. The other option is to use a copier/scanner, and either email from the copier/scanner, or upload to a mobile device (thumb drive) and email from your computer.

Credit Card Authorization Form

  • Please enter the name as it appears on the card.
  • Accepted file types: jpg, gif, png, pdf.
    Please take a photo or copy of the front and back sides of your government issued ID and credit card and upload images here.
  • Date Format: MM slash DD slash YYYY