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    240726_247 Autopay Authorization Form

    Uploaded by

    zoeeeee0911

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    240726_247 Autopay Authorization Form

    Uploaded by

    zoeeeee0911
    9 views1 page

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    9 views1 page

    240726_247 Autopay Authorization Form

    Uploaded by

    zoeeeee0911

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Autopay Authorization Form 自動轉賬授權表格

    本人授權 貴公司於本人信用卡戶口收取以下款項

    This is to authorize your company to charge my credit card for the

    客戶姓名 Customer Name : ______________________________________________

    會員編號 Membership Number : ___________________________________________

    月付金額 Monthly Payment: __________________________________________________

    信用卡號碼及信用卡種類 ( 請選擇)

    Credit Card Number & Type of Credit Card (Please tick)

    信用卡號碼 Card Number : ____________________________________________________

    信用卡類別 Card Type : □ Visa □ Master Card □ AE □ Union Pay

    信用卡有效期至 信用卡安全碼

    Card Expiry Date: ___________________ Card Security Code: ______________

    持卡人姓名 ( 請以正楷填寫)

    Cardholder’s Name (Please print):________________________________________

    持卡人簽署

    Cardholder’s Signature: _________________________________________________

    電話號碼: 日期:

    Telephone: _____________________ Date: _______________________

    Stripe Authorization Form (210503)

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