CREDIT CARD AUTHORIZATION | St. George UT

Client Credit Card Authorization Form

Name on Card

DOB

Billing Address

Billing Zip

Phone

Cleaning Service/Schedule

Authorized Amount $

Type of Card

Card Number

Expiration Date

Security Code

I agree that cancellations must be communicated within 48 hours before cleaning services are performed, otherwise a $50.00 fee will be charged. MINIMAL IMPERFECTIONS such as dirt, crumbs, fingerprints,etc...,inadvertanly left behind by our cleaners, or any unreasonable irregularities are not grounds for a discount.

As an authorized cardholder or corporate officer, by submitting this form, I understand and agree to the terms set forth in this agreement, agree to pay, and specifically authorize to charge my credit card for the services provided. I further agree that in the event my credit card becomes invalid, I will provide a new valid credit card upon request, to be charged for the payment of any outstanding balances owed.

I am aware that charges made for actual services performed by Cleaning Dino are non-refundable. In the event of pre-payment, any unused funds will be refunded within 30 days. Further, I understand that a service charge of $50 will be added to my final bill if my home is not reasonably DECLUTTERED prior to my scheduled-service.

Your Signature

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Client Credit Card Authorization Form

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Client Credit Card Authorization Form

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