Bcc Authorization Form 3

Published on May 2016 | Categories: Documents | Downloads: 62 | Comments: 0 | Views: 437
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The Credit Doctor Credit Services
2221 PEACHTREE ST NE 106 Atlanta, GA 30309 CREDIT CARD AUTHORIZATION FORM Business/Personal Credit Card Program

CREDIT CARD TYPE:
CREDIT CARD NUMBER: COMPANY NAME: CARD HOLDER NAME: BILLING ADDRESS: CITY/STATE/ZIP: PHONE: FAX:

VISA

MASTERCARD

DISCOVER

DINERS

AMERICAN EXPRESS

EXP:

AMOUNT TO CHARGE: $ 3 or 4 digit code on back of card

I, ___________________________________________________, authorize my credit card to be charged for the above amount. I am aware that I will receive a copy of the email confirmation and that this confirmation will act as my record of this transaction. Please PRINT this form, sign and submit it to our office. Sign: _____________________________________ Date: ______________

Terms and Conditions You agree to the following terms and conditions: You acknowledge that there is a refundable $150.00 processing fee to be approved for the benefits though the The Credit Doctor Credit Services High Limit Credit Card Services. By

submitting this member application, you also acknowledge that The Credit Doctor Credit Services Application Review Department will not begin the review the member application review process without a successful payment. Your member application fee can be paid by one of the following methods which you have the option of selecting above under Your Payment Method:
• •

Paypal Credit Card (complete form above or through Paypal)

Although The Credit Doctor Credit Services member application Review Department will make every attempt to approve your member application, you understand that in the event your member application is not approved, 50% of your member application fee will be refunded within 7-14 days of failed approval. The Credit Doctor Credit Services High Limit Credit Card Services is not a direct lender. The Credit Doctor Credit Services High Limit Credit Card Services is a direct property buyer that facilitates lease-to-purchase programs. The Credit Doctor Credit Services negotiates home purchase agreements with financial institutions.

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