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Credit card Authorization
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To:
Email:
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Jordan Court Apts
Jordancourtapts@yahoo.com
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Fax:
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we have no fax
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From:
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Date:
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Address
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APT#
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Pages:
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1
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RE:
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Credit card authorization
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I authorize the processing of my credit card to cover charges due Jordan Court Apartments. I agree to all terms and conditions set forth by Jordan Court Apartments and understand that I am required to pay a 3% convenience fee on the total charges below.
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Type of Credit Card: ( circle one)
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Visa MasterCard Discover
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Credit Card Account #
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__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
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Expiration Date:
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Verification(sec code) on back 3 digits:
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______ ______ ______
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Amount to be Charged:( rent x.03=fee)
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$____________ + 3% ________ = $____________
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Phone #:
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Area code ( )
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Card holders name as appears on card:
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Credit card billing address:
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City, State, Zip Code:
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Payment for( Tenants Name):
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Tenants Apartment address:
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Authorized Signature:_________________________________________________________