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Credit Authorization Form
Customer Name
Authorizing Individual NameFirst / Last
Authorizing Email AddressEmail of Authorizer
Authorizing Individual Phone Number(xxx) xxx-xxxx
Last 4 Digits of Authorized Credit Card NumberCall for first 12
Authorized Card Expirationmm/yy
Authorized Security CodeCCV
Authorized Card Billing Zip CodeBilling Address Zip
Authorized AmountIf applicable
Invoices/Work Orders to be AppliedIf applicable
0 /

By typing my name in the box below, I acknowledge that, and authorize Vanco to store my Credit Card info on file (see Disclaimer below) for any current and future work, and charges will only be made with my approval.

Authorizing SignatureFirst / MI / Last

Disclaimer: Vanco uses a secured, third-party provided (PayTrace) for all credit card transactions. Any credit card information is only stored with this secured third-party and will not be stored in any Vanco software, directly. 

Equipment Warranty: Some products or equipment may be covered by warranty or its manufacturer. Vanco does not assume any responsibility for these warranties at any time. We will make all reasonable attempts to obtain warranty coverage by the manufacturers we represent, but the customer will be responsible for any charges (including but not limited to, labor, travel, overtime, parts, and special shipping) not covered by the manufacturer's warranty, including denied warranty claims for reasons outside of manufacturer's coverages.

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