Credit Card Authorization Form

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Secure Credit Card Authorization Form

Phone *

Card Holders Full Address *

Expiration Date *

CVC Number *

Credit Card Type *

Credit Card Number *

Card Holders Full Name *

By Typing your name below, it acts as your signature and You authorize Pet Doodie Waste Management Services to charge your credit card above for agreed upon services. You understand that this is an electronic transaction and funds will be withdrawn from your account. You understand that services can be canceled at anytime and must be submitted in an email requesting to cancel or by phone with a 7 day notice. You understand that if an NSF (non sufficient funds) occurs, a redraft will take place on the 3rd, 5th and 7th day. After the 3rd attempt and the account is still NSF, your account will be placed on hold and services will be canceled until a new card or funds become available. You certify that you are an authorized user of this credit card/bank account and will not dispute these scheduled transactions with your bank or credit card company; so long as the transactions correspond to the terms set up. *