Credit Card Authorization Form

To put a credit card on file for your account, please contact our customer service department at 800-876-4363 or to provide your payment information. An authorization form will then be generated with the information you provide. The authorization form will be emailed or faxed to you, and it will need to be signed by the cardholder and returned to us.

The information needed in order for us to generate the authorization form would be:
– credit card number
– expiration date
– CVV code from the back of the card
– cardholder name as it appears on the card
– billing address for the card
– fax number or email address where we should send your authorization form to be signed

We accept Visa, Mastercard, or Discover cards.