Around Atlanta Limousines Inc.

404-447-5496
www.aroundatllimos.com
info@aroundatllimos.com

 

CREDIT CARD AUTHORIZATION FORM

Please circle one:

  • American Express        Visa        Mastercard        Diners Club        Discover

Please circle one:

  • Personal Card            Corporate Card


  • Credit Card Number:                                                                            Expiration Date:


  • Name as it appears on the card:                                                          Billing Address:                                                                                                                CVV:


  • Company Name if corporate card:


THE FOLLOWING MUST BE COMPLETED BY THE CARDHOLDER FOR THE CREDIT CARD INDICATED ABOVE AND SIGNED BY THE AUTHORIZED USER ONLY.



I , _________________________, AUTHORIZE, AROUND ATLANTA LIMOUSINES INC., AND IT'S COMPANIES TO CHARGE THE CARD ABOVE FOR GROUND TRANSPORTATION SERVICES. PLEASE LIST ALL PERSONS AUTHORIZED TO CHARGE SERVICES TO THIS CARD.

NAME:__________________________________________PHONE:______________________________
NAME:__________________________________________PHONE:______________________________ .

PLEASE INDICATE BELOW IF SERVICES ARE FOR SINGLE OR MULTIPLE USES.

  • SINGLE USE ( )                                                    MULTIPLE USE ( )



  • SIGNATURE OF CARDHOLDER                                                    DATE/DATES                                                                               PHONE NUMBER



A COPY OF BOTH SIDES OF THE SIGNED CREDIT CARD MUST BE SUBMITTED WITH THIS FORM.