ANDREW J. STOSKOPF TRUCKING, INC.
WARROAD, MN | 218-386-4810
CREDIT / DEBIT CARD ON-FILE AUTHORIZATION
Fillable form - complete & sign. Enter full card details ONLY through AJS secure payment collection.
CUSTOMER & PAYMENT CARD DETAILS
Customer / Cardholder Name
First Name
Last Name
AJS Customer / Business Name (if different)
Billing Email (invoice & payment notices)
example@example.com
Phone Number
Format: (000) 000-0000.
Card Number
Card Expiration (MM/YY) - optional
CVV
Billing Zip Code
Card Type
Credit card
Debit card
AUTHORIZATION FOR CARD-ON-FILE CHARGES AFTER THE INVOICE DUE DATE
I authorize Andrew J. Stoskopf Trucking, Inc. (AJS) and its secure payment processor to retain a payment token for the credit/debit card identified above and to charge that card for outstanding snowplowing invoices on my customer account. This is a BACKUP PAYMENT AUTHORIZATION, not a charge at the time of signing. AJS will first issue an invoice stating the charges and due date. I may pay by another accepted method before the due date. If an invoice remains unpaid after the due date, I authorize AJS to charge the remaining unpaid balance on the FIRST BUSINESS DAY AFTER THE DUE DATE, without obtaining additional permission for each invoice. Each amount varies with work completed and will not exceed the amount owed on the applicable invoice.
I authorize this merchant-initiated, stored-credential transaction arrangement for the 2026-2027 snowplowing season and thereafter only for unpaid invoices from services I authorized, unless revoked. I may cancel FUTURE card charges by notifying AJS at 218-386-4810 or in writing at PO Box 23, Warroad, MN 56763 before processing. Cancellation does not eliminate charges for services already provided. AJS may require an alternate valid payment method to continue automatic-route service. I confirm I am an authorized card user.
I authorize the card-on-file charge terms above.
Authorized Cardholder Signature (type name OR sign after printing)
Date (MM/DD/YYYY)
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
A typed name is not a verified e-signature by itself; use an approved e-sign workflow or ink-sign the printout.
2026-2027 Snow Plowing Season | Customer copy must be provided after authorization.
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