Credit Card Authorization Form

* FAX COMPLETED FORM TO ACCOUNTING @ (619) 685-1124*

CalExpress is authorized to charge your card for the amount of the charges incurred to complete the Order(s) submitted, as described in either your letter of instruction or other means, including this authorization.

◊ On this date(s)
◊ Invoice Number
For Ongoing Charges One Time Charge
◊ Dollar Amount $
     
Cardholders Name:
Business Name:
Address Associated:
Telephone:
Fax:
Email Address:
ACS Account Number:
Check one:
VISA MASTERCARD DISCOVER AMEX
Card #:
3 Digit Sec #:
Billing Zip Code:
Exp. Date:
I certify that I am the holder of the above credit card, or have been authorized by the holder, to use it to pay for services provided by CalExpress, Inc. and I agree to all of the terms and conditions.
Signature:
Date:
This Authorization form is required for new clients and clients outside of California. For Clients in California, your first Order is always charged to a credit card. For clients outside California, all Orders will be charged to your card, unless prepaid by check. Once credit has been established, this authorization is a guarantee of payment. CalExpress, Inc. reserves the right to charge your card for past due balances not paid within our credit terms. Because most of these transactions are performed electronically, it is not required that CalExpress, Inc. keep a physical credit card on file in order for the charge to the card to be valid. I UNDERSTAND THE CHARGE FOR THE ABOVE SERVICE IS NON-REFUNDABLE, NON-REVOCABLE, AND NON-CONTESTABLE. I WAIVE MY RIGHT OF REFUND AND/OR TO DISPUTE THE CHARGE.
CalExpress, Inc. reserves the right to restrict the credit of any client for any reason.
It is further agreed that this contract is negotiated in San Diego, CA.