Get Debit Card Authorization

Filling out the Debit Card Authorization form is a straightforward process that allows users to authorize monthly or one-time charges for services provided by Concord Communications Group, Inc. This guide will assist you in accurately completing each section of the form, ensuring a smooth authorization experience.

Follow the steps to complete your authorization form online.

1. Click ‘Get Form’ button to access the Debit Card Authorization form and open it in the online editor.
2. Enter the date on which you are filling out the form. This makes it clear when your authorization is effective.
3. Provide your customer or company name in the designated field to identify who is authorizing the payment.
4. Fill in your contact name, email address, and telephone number to ensure you can be reached if there are any questions regarding the authorization.
5. Specify the service description, such as monthly recurring charges, repairs as needed, or equipment purchases, to clarify what the charges will entail.
6. Indicate the recurring amount you wish to authorize by filling in the dollar amount at the time of signing.
7. If applicable, enter any one-time amounts in the corresponding field.
8. Fill in the start date for recurring billing. Note that bills are processed on the first of each month, and prorating will occur for the first invoice, if your start date is not the first.
9. Select your credit or debit card type by checking the appropriate box for Visa, MasterCard, Discover, or AMEX.
10. Provide the cardholder name as it appears on the card to ensure accuracy in billing.
11. Fill in the zip code corresponding to the cardholder's billing address.
12. Enter the cardholder's street address.
13. Provide the expiration date of the card to validate its usability.
14. Enter the CCV number for an added layer of security on your card.
15. Sign in the designated area to confirm your authorization for charges. This section is crucial as it indicates your consent.
16. Once you have completed all fields, save your changes, and choose to download, print, or share the form as needed.

Complete your Debit Card Authorization form online today for seamless processing of service charges.