Payment Authorization Form Instructions

This payment authorization form from Comcetera Ltd instructs users to print the form, fill it out with black ink, take a photo of their photo ID and the completed form, and upload or fax it. It authorizes Comcetera to charge the provided credit/debit card for services and agrees to the cardholder agreement terms, and requests the last 4 digits of the card and type of photo ID used to verify identity.

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Payment Authorization Form Instructions

Uploaded by

chap weird

We take content rights seriously. If you suspect this is your content, claim it here.

Available Formats

Download as PDF, TXT or read online on Scribd

PAYMENT AUTHORISATION FORM CC-PAF-16

INSTRUCTIONS:

1) Print this form and complete in black ink

2) Photograph the completed form and your photo ID

3) Upload at https://secure.comcetera.com/verify or fax to +44 1202 237101

CARD AUTHORISATION:

I authorise Comcetera Ltd to charge my credit/debit card for services provided, and
agree to pay my card issuer according to the terms of my cardholder agreement.

Last four digits of card:

Type of photo ID: [ ] Driving licence

[ ] Passport

[ ] Other:

Name as shown on card:

Cardholder signature:

comcetera ltd is registered in england and wales, company 6058188

registered office: 13 freeland park, poole, dorset bh166fh

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Payment Authorization Form Instructions

Uploaded by

Payment Authorization Form Instructions

Uploaded by

PAYMENT AUTHORISATION FORM CC-PAF-16

1) Print this form and complete in black ink

2) Photograph the completed form and your photo ID

3) Upload at https://secure.comcetera.com/verify or fax to +44 1202 237101

Last four digits of card:

Type of photo ID: [ ] Driving licence

Name as shown on card:

comcetera ltd is registered in england and wales, company 6058188

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