Credit Card Authorization for Recurring Payments

Schedule your payments to be automatically charged to your credit card. Just complete and sign this form to get started!

Recurring Payments Will Make Your Life Easier:

It’s convenient (saving you time)
Your payment is always on time (even if you’re out of town), eliminating late charges
Cancel anytime

Here’s How Recurring Payments Work:

You authorize regularly scheduled charges to your Visa or MasterCard. You will be charged the day of the service and the charge will appear on your credit card statement. You agree that no prior-notification will be provided if the total payment is less than $ (amount entered below) per service. If your bill is more than that amount (service upgrade) the amount will be agreed upon prior to the payment.

Payment Notification Minimum (in Dollars)

Billing Address

Enter the street address on your billing statement

Billing City

Enter the city on your billing statement

Billing State

Enter the State on your billing statement

Billing Zip Code

Enter the Zip Code on your billing statement

Phone

Enter your contact phone number

Email *

Enter your email address

Card Holder Name *

First

Last

Credit card numbers

Please enter your full credit card number

Credit Card Expiration Date

Please enter your credit card expiration date (XX/XX)

Credit Card CVV Number

Please enter your credit card 3-digit security code on the back of your card (4 digit code on front of AMEX)

Additional Tip Amount

Please enter your tip amount (optional)

Digital Signature

Please enter your full name as your digital signature. I authorize the above named business to charge the credit card indicated in this authorization form according to the terms outlined above. If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify the business in writing of any changes in my account information or termination of this authorization at least 5 days prior to the next billing date. This payment authorization is for the type of bill indicated above. I certify that I am an authorized user of this credit card and that I will not dispute the scheduled payments with my credit card company provided the transactions correspond to the terms indicated in this authorization form.

Our Service Area

Our North Austin location proudly serves the North Austin suburbs of Cedar Park, Leander, Jonestown, and Round Rock.

Our San Antonio office serves the following zip codes: 78216, 78217, 78229, 78230, 78231, 78232, 78233, 78238, 78240, 78247, 78248, 78249, 78250, 78254, 78255, 78256, 78257, 78258, 78259, 78260, 78261, 78266