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One Time Use Credit Card Authorization Form

Gift A Trip

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CREDIT CARD AUTHORIZATION

 

I,  , hereby authorize Partner-Ship Solutions, LLC DBA Gift A Trip to charge my credit card for the agreed upon purchases on or after the indicated date. This is permission for a single transaction only and does not provide authorization for any additional unrelated debits or credits to your account.

The payment is for the following purchase:  

BILLING DETAILS

Card Holder Billing Address:

 

 

 

 

 

CREDIT CARD DETAILS

CHOOSE YOUR CARD TYPE:

 

 

 

I authorize the above-named merchant to charge the credit card indicated in this authorization form according to the abovementioned terms. This payment authorization is for the goods/services described above, for the amount indicated above only, and is valid for one (1) use only. I certify that I am an authorized user of this credit card and will not dispute the payment with my credit card company.

I acknowledge that I have reviewed and accept the TERMS & CONDITIONS as set forth by Partner-Ship Solutions, LLC DBA Gift A Trip.   

 

ALL CERTIFICATES ARE NON-REFUNDABLE ONCE PURCHASED.
4% MERCHANT FEES MAY APPLY.   

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One Time Use Credit Card Authorization Form

Gift A Trip

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