Credit Card Charge Authorization
Click on "Download File" below to open the document in a new window. You will then be able to print, complete the form with the information required and follow the directions on the form. You may return to us one of three ways:
* Scan and email to the address on the form
* or Snap a photo with your smart phone and email to the address on the form
* or Fax. Please phone our office for the fax number.
The form indicates the email where you can return the completed form.
* Scan and email to the address on the form
* or Snap a photo with your smart phone and email to the address on the form
* or Fax. Please phone our office for the fax number.
The form indicates the email where you can return the completed form.
| client_credit_card_authorization_form_dta__19jun18.pdf |
