Credit Card Authorization

Credit Card Authorization Form

Credit Card Authorization
Authorizing Name on the Card
Authorizing Name on the Card
First Name
Last Name
Authorizing Billing Address
Authorizing Billing Address
City
State/Province
Zip/Postal
Call for first 12
If applicable
If applicable

Acknowledgement

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.
Authorize
This will serve as your acting/official signature
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.