Credit Card Verification and Limit Increase Agreement

To verify a credit card or apply for a limit increase, please complete the agreement below:

  1. For each credit card, enter the account information and print the form.
  2. In the space provided at the bottom of the agreement, make an imprint of your credit card by placing the card under the printed form and very lightly rubbing a pencil over the top.
  3. Sign and date the bottom of the agreement.
  4. Fax the Credit Card Verification Agreement(s) along with:
A photocopy of your picture ID (e.g. Drivers License)
Photocopies (front and back) of your credit card
A photocopy of one other ID piece (passport or mailed credit card statement)

To avoid processing delays, please ensure that the name, address, card number and signature on your submitted documents are clearly legible.

 
Client Information
Your Name:
Credit Card Number:
Expiration:
 Month    Year     
Name of Issuing Bank:


Telephone # of Issuing Bank
(toll free # on back of card):

Purchase Limit with Credit Card Issuer:

Address on File with Credit Card Issuer:


Requested monthly purchase limit:
$ per month

IMPORTANT: Please read the following carefully before signing and dating.

By submitting this signed and dated form, along with the additional information requested, I am authorizing and fully acknowledging that:

a) I am the person who opened this account personally, entered into all transactions, and deposited funds using the above credit card.

b) I will honor all deposits made in my account and pay for them in full, whether purchases made by telephone or by Internet.

c) I am over 18 years of age

d) I have read and accepted the terms described in the Transaction Processing Agreement.



     


Making an Imprint of your Credit Card
  1. Place Credit Card under box outline
  2. Rub pencil very lightly over card
  3. Ensure your name, number, & expiration date are clear and readable


FAX TOLL FREE TO: 1-866-422-3256
or scan and email to cashier@Suite332.com
 
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