CREDIT CARD AUTHORIZATION | St. George UT

Client Credit Card Authorization Form

Name on Card

DOB

Billing Address

City/State/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 service is performed, otherwise a $50.00 fee will be charged. Minimal debris i.e crumbs, fingerprints,etc...inadvertanly left behind by our cleaners, or any unreasonable complaint 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 cleaning.

Thank You! We will email you shortly.

Client Credit Card Authorization Form

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Client Credit Card Authorization Form

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Contact Information

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