Credit Card Authorization - Munro Enterprises, LLC

Credit Card Authorization Form

Job # *

Invoice #

Company Name

Individuals Name *

First

Last

Phone *

Email *

Credit Card Billing Information

Type Of Credit Card (Please Check One) *

American Express
Master Card
Visa
Discover

Dollar Amount To Be Charged: *

Name On Credit Card: *

First

Last

Credit Card Number: *

Expiration Date: *

Verification Code (Three or four digits on back signature panel or front of card): *

Card Billing Address:

Address Line 1

City

State

Zip Code

Phone (If Different Then Above)

Email Receipt (If Different Then Above)

Agreement:

Agreement: This agreement is entered by the above-named client and Munro Enterprises, LLC. Client acknowledges that the name printed above is the name as it reads on the credit card, and the signature below is the authorizing signature for this credit card. Client authorizes Munro Enterprises, LLC. to charge the above credit card for all security deposit(s) and charges resulting from Rental Contract. Client must either sign for all equipment or list users below who can sign on Client’s behalf. Client’s (or authorized users) signature or Rental Contract is acknowledgment for the receipt of all equipment and services stated. Client agrees to abide by Munro Enterprises, LLC. rental Terms & Conditions and agrees to pay all fees stated (including charges resulting from, but not limited to, lost or damaged equipment and additional use charges). A one (1) day rental will be charged if cancellation notice is not received one (1) week prior to event date regardless of equipment delivery.

Additional Authorized Account User:

Card Holders Digital Signature: (Please Use Your Finger/Mouse To Sign) *

Todays Date: *

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