Credit Card Authorization Form

Credit Card Authorization Form

Please fill out this form to sign up for recurring payments or to pay your lease in full.
Cardholder Name*

First NameMiddle NameLast NameSuffix

Entire Lease Amount(USD one-time payment)

Please compare this number to the number on your lease agreement.

Monthly Rent(USD for each month)

Please compare the subscription amount to reflect the same on your lease agreement.

Recurring payments

Payment Method
Credit	Express

ConditionText
I, {cardholderName}, as a cardholder, hereby authorize KJSTAYS (ABOSS LLC) to charge my credit card for {conditiontext} and confirm that the information for the credit card and billing address is complete and accurate. I have been informed that I can cancel the recurring payment at least 15 days before the payment by phone or signing a consent form provided by the merchant company.
Date*

MonthDayYear
Date
Cardholder Signature*
Should be Empty: