ONE-TIME CREDIT CARD PAYMENT

*REQUIRED
*REQUIRED
*REQUIRED
*REQUIRED
*REQUIRED
*REQUIRED
*REQUIRED
*REQUIRED
*REQUIRED
*REQUIRED
*REQUIRED
*REQUIRED

EMAIL ADDRESS (monthly invoice will be emailed to this address)


*REQUIRED

I authorize Tenant Data to charge the credit/debit card listed above and for the issuer or financial institution to pay the amount indicated above due Tenant Data for services or otherwise per this authorization.  I authorize Tenant Data to retain this payment information for future transactions but do not authorize Tenant Data to make additional charges (other than as permitted by this authorization) without further authorization.

 

I certify that I am an authorized user of this credit/debit card and will not dispute these transactions with my issuer or financial institution, so long as the transactions correspond to the terms indicated in this authorization form. If I dispute a legitimate obligation owed to Tenant Data, I acknowledged I will be charged and agree to pay a chargeback fee of $15.00 per transaction, which will be initiated as a separate transaction.

 

I acknowledge and agree that if any amount that I owe Tenant Data is unpaid after 30 days from invoice date or is referred to collection, I shall pay all of Tenant Data's reasonable collection costs, including attorney fees, and court costs.

*REQUIRED