Excel Digital Marketing

Credit Card Authorization

Credit Card Authorization Form


Please complete all fields. You may cancel this authorization at any time by contacting us. This authorization will remain in effect until cancelled.


Credit Card Information:

Card Type:   


Cardholder Name (as shown on card):  

Card Number:  

Expiration  Date (mm/yy):    Security Code:  

Cardholder ZIP Code (from credit card billing address):  

I, , authorize Excel Digital Marketing, Inc. to charge my credit card above for agreed upon purchases. I understand that my information will be saved to file for future transactions on my account.


Customer Signature:

Leave this empty:

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Signature Certificate
Document name: Credit Card Authorization
lock iconUnique Document ID: a5a5d35d53fecd3887ea095d2b3020a158faac55
Timestamp Audit
December 7, 2018 11:28 am EDTCredit Card Authorization Uploaded by Kevin Harbour - reoking@gmail.com IP