Credit Card Authorization Form by Rolando Herrera April 21, 2020 Name on the Card *Billing Address *Billing Zip Code *Credit Card Number *Expiration Date *Card Identification Number (CVV) *last 3 digits located typically on the back of the credit cardCheckbox *I AgreeI authorize Insignia SEO to charge the credit card indicated in this authorization form in accordance with the Invoice sent out. If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify the business in writing of any changes in my account information or termination of this authorization at least 30 days prior to the next billing date. This payment authorization is for the type of bill indicated above. I certify that I am an authorized user of this credit card and that I will not dispute the scheduled payments with my credit card company provided the transactions correspond to the terms indicated in this authorization form. Monthly Invoices will be charged the 1st of the month.Submit
