Authorization to Use Credit Card on File


I, , authorize Imperative Information Group, Inc. (“Imperative”) to charge the credit card listed below for the total amount of any invoices issued to  (“the Company”).

I certify that I have the authority to enter into this agreement on behalf of the Company and utilize this credit card for such payments.

I understand that this information will be saved to file for all future invoices issued to the Company.

I understand that this authorization can be cancelled at any time by contacting Imperative and that this authorization will otherwise remain in effect until cancelled.

 

Cardholder Name:   

Credit Card Number:  

CVC:  

Expiration Date:   

Billing Zip Code:   

Leave this empty:

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Signature Certificate
Document name: Authorization to Use Credit Card on File
lock iconUnique Document ID: ed8784321381cb542161389775c33a5581d00762
Timestamp Audit
January 20, 2021 4:01 pm CDTAuthorization to Use Credit Card on File Uploaded by Imperative Form Builder - 1xsupport@imperativeinfo.com IP 47.4.49.69
January 20, 2021 4:05 pm CDTImperative Information Group - ccauthorization@imperativeinfo.com added by Imperative Form Builder - 1xsupport@imperativeinfo.com as a CC'd Recipient Ip: 47.4.49.69