Credit Card Form USA – Startower Transports

Payment Authorization Form

Layout

STAR TOWER TRANSPORTS PAYMENT AUTHORIZATION *

Layout

CARDHOLDER FULL NAME *

CARDHOLDER PHONE *

CARD LAST 4 DIGITS *

Expiration Date *

CARDHOLDER EMAIL *

CARDHOLDER FULL BILLING ADDRESS *

CVC/CVV CODE *

PAYMENT TOTAL AMOUNT *

Photo I.D /Licensed

Click or drag a file to this area to upload.

Photo of Payment Card

Click or drag a file to this area to upload.

Terms & Conditions *

I authorize to charge my credit / debit card for agreed upon service offered. I understand this purchase is final. If additional fees are needed for any reason we will request it, to complete services. I understand ETA’s are an estimate and can change. I understand I will not be refunded once services are provided. Please be advised that there will be a cancellation charge of the full amount quoted. No exceptions will be made to the no refund policy, except in cases of technical failures on the company’s part that prevent delivery of the service. This is subject to change but will be enforced when cancellation is due to but not limited to GOA (gone on arrival), changing of service provider, or not needing service after a driver has been dispatched, or dispute of ETA time given being extended due to matters out of our control. There will be a full cancellation fee if any reason accrues and the client decides to cancel. I certify that I am an authorized user of this credit/debit card and that I will not dispute the payment with my credit/debit card company so long as the transaction corresponds to the terms indicated in the form.

Signature

STAR TOWER TRANSPORTS PAYMENT AUTHORIZATION

CARDHOLDER FULL NAME *

CARDHOLDER EMAIL *

CARDHOLDER PHONE *

CARDHOLDER FULL BILLING ADDRESS *

CARD LAST 4 DIGITS *

CVC/CVV CODE *

Expiration Date *

PAYMENT TOTAL AMOUNT *

Photo I.D /Licensed

Click or drag a file to this area to upload.

Photo of Payment Card

Click or drag a file to this area to upload.

Terms & Conditions *

I authorize to charge my credit / debit card for agreed upon service offered. I understand this purchase is final. If additional fees are needed for any reason we will request it, to complete services. I understand ETA’s are an estimate and can change. I understand I will not be refunded once services are provided. Please be advised that there will be a cancellation charge of the full amount quoted. No exceptions will be made to the no refund policy, except in cases of technical failures on the company's part that prevent delivery of the service. This is subject to change but will be enforced when cancellation is due to but not limited to GOA (gone on arrival), changing of service provider, or not needing service after a driver has been dispatched, or dispute of ETA time given being extended due to matters out of our control. There will be a full cancellation fee if any reason accrues and the client decides to cancel. I certify that I am an authorized user of this credit/debit card and that I will not dispute the payment with my credit/debit card company so long as the transaction corresponds to the terms indicated in the form.

Signature