CREDIT CARD AUTHORIZATION

Client Credit Card Authorization Form

Name on Card

Billing Address

Billing Zip

Phone

Card Number

Expiration Date

Security Code

If I cancel my scheduled service on the same day, I will be charged a fee of $150. If I cancel within 48 hours but not on the same day as the scheduled service, I will be charged a fee of $100.

By submitting this form as an authorized cardholder or corporate officer, I acknowledge and accept the terms of this agreement. I agree to pay for the services provided and authorize the use of my credit card for these charges. Should my credit card become invalid, I agree to provide a new, valid credit card on the same day to cover any outstanding balances. A $25 processing fee will be applied if my card is declined, with an extra $25 added to the final bill for each day the payment remains unsettled.

I understand that any charges incurred for services performed by Cleaning Dino are non-refundable. If I have made a pre-payment, any unused portion will be refunded within 30 days. Additionally, I acknowledge that if my home is not reasonably decluttered before the scheduled service, a service charge of $50 will be added to my final bill.

Minor imperfections such as dirt, crumbs, fingerprints, etc... left behind by our cleaners, as well as any unreasonable irregularities, do not qualify for a discount.

Your Signature

AR (501) 680-3145

UT (435) 669-6898

CLEANING DINO

Client Credit Card Authorization Form