Examples of Card Type in a sentence
Option 1: Automated Credit Card Charge Card Type: Visa Mastercard Amex Discover Cardholder Name: Credit Card Number: Expiration Date: / Cardholder Signature: I authorize Operator to automatically charge my credit card on a recurring basis to pay any sums due from me for parking charges payable under my Agreement for Monthly Parking Privileges.
I hereby authorize Midwest Orthopaedic Consultants to use my credit card for copays, co-insurance, non-covered services, or other balances that are my financial responsibility if not paid within 45 days of service.Credit Card Type # Expiration .
Xn Option 1: Automated Credit Card Charge Card Type: Visa Mastercard Amex Discover Cardholder Name: Credit Card Number: Expiration Date: / Cardholder Signature: I authorize Operator to automatically charge my credit card on a recurring basis to pay any sums due from me for parking charges payable under my Agreement for Monthly Parking Privileges.
Please circle one.Select Card Type: VISA AMERICAN EXPRESS MASTERCARD DISCOVER Credit/Debit Card Number Expiration date Billing Zip Code Security Code ____CHECKING ACCOUNT I have enclosed a copy of a voided check from my checking account.
Account Holder Name Billing Address City-State-Zip Credit Card Type Visa MasterCard Discover Amex ACH Amount Charged (USD) $ I authorize Riverside Golf Course to charge the agreed amount listed above to the account provided herein between the 5th and 7th day of each month.