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Ramada Credit Card Authorization Form

This document is a credit card authorization form for monthly parking charges at the Ramada Parking Lot. It contains the customer's contact and vehicle information as well as credit card details. The customer authorizes Allied Parking, Inc. to charge the provided credit card monthly for incurred parking charges between the 1st and 5th of each month. The customer is responsible for canceling the credit card authorization with their credit card company upon terminating their parking. If they fail to do so, Allied Parking's liability is limited to a maximum of two months of parking payments. The agreement is also subject to the parking lease for the Centre Village Ramp.

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1K views2 pages

Ramada Credit Card Authorization Form

This document is a credit card authorization form for monthly parking charges at the Ramada Parking Lot. It contains the customer's contact and vehicle information as well as credit card details. The customer authorizes Allied Parking, Inc. to charge the provided credit card monthly for incurred parking charges between the 1st and 5th of each month. The customer is responsible for canceling the credit card authorization with their credit card company upon terminating their parking. If they fail to do so, Allied Parking's liability is limited to a maximum of two months of parking payments. The agreement is also subject to the parking lease for the Centre Village Ramp.

Uploaded by

CarlaDunham
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Ramada Parking Lot CREDIT CARD AUTHORIZATION

Name: ________________Account Number: _____________ Email:_______________


Billing Address:________________ City:_________State:____ Zip:_______________
Business Address:_______________ City:_________State:____ Zip:_______________
Home Phone:____________ Business Phone: ____________Fax: __________________
Vehicle
Make:

Vehicle
License:

Drivers
Lic. No.:

Parking to commence: January 01, 2015


I hereby authorize Allied Parking, Inc. to charge my credit card on a monthly basis for
parking charges incurred each month. Credit cards will be charged between the first and
the fifth of each month.
Credit Card
Visa

M/Card

AMEX

Expiration Date

Discover
Last 3 digits

Card Number

Amex Number

on back of card

Valid Date
Signature/ Authorization

Date
It is the customers responsibility to cancel the authorization with their credit card company upon
proper notification to Allied Parking, Inc. of their termination of parking. If the customer fails to
do so, the liability of Allied Parking, Inc. is limited to a maximum refund of two (2) months
parking payments.
All rejected transactions carry a $25.00 administrative fee.
This agreement is subject to the Parking Agreement (Lease) for the Centre Village Ramp.

I ACCEPT AND AGREE TO THIS MONTHLY PARKING AGREEMENT WITH Allied Parking, Inc.. I ACKNOWLEDGE
THAT I HAVE READ AND AGREE TO THE TERMS AND CONDITIONS LISTED ABOVE, AS WELL AS THE
MONTHLY PARKING AGREEMENT (LEASE) FOR THE CENTRE VILLAGE RAMP.

SIGNATURE/ AUTHORIZATION:______________________

DATE: _______________

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