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Credit Card Auth

This credit card authorization form collects information needed to process an offline credit card payment, including the card holder's name, credit card number and expiration date, CVV number, payment amount in Indian rupees and words, card holder ID proof number, and requires the card holder's signature and date to authorize charging the card for the listed amount.

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Vikas Kumar
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138 views2 pages

Credit Card Auth

This credit card authorization form collects information needed to process an offline credit card payment, including the card holder's name, credit card number and expiration date, CVV number, payment amount in Indian rupees and words, card holder ID proof number, and requires the card holder's signature and date to authorize charging the card for the listed amount.

Uploaded by

Vikas Kumar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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CREDIT CARD AUTHORISATION FORM

CARD HOLDERS NAME


CARD NO WITH EXPITY DATE
CARD TYPE [VISA /MASTER / AMEX]
CVV NO
PAYMENT AUTHORISING FOR
[GUESTS NAME SHOLD BE
MENTIONED]
TOTAL PAYMENT IN INR
TOTAL PAYMENT IN WORDS
CARD HOLDERS ID PROOF NO:
[PASSPORT NO / VOTER CARD NO / PAN
NO / DRIVING LICENSE NO]

To take the payment through Credit card Offline Swipe, Card holder need to provide
all the above mentioned informations along with scan copy of the credit card [both
side].

In lieu of my credit card imprint & Payment authorization, I.


hereby authorize Sarovar Portico Jalandhar to charge my above Credit Card for the
amount shown above. By signing below, I acknowledge the charges described above.

______________________

______________________
Date

Card Holder's Signature

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