Credit Card Authorization Form - Invoice Payment Authorization - Auto Charge and Approval Terms

Sep 17, 2026

Credit Card Authorization Form用于授权信用卡为发票支付。表单收集客户/企业信息、卡信息（账号、CVV/CSV/MC、卡片姓名、到期日）、持卡人账单地址与邮寄收据邮箱。授权部分填写SLS编号的发票号与金额，并说明3.5%交易手续费将自动计入总额。文档还规定：若在请求审批后5天无回应将自动扣款；逾期或拒付卡需15天内更新，否则可能收取1.5%费用并按月继续扣款；拒付退款相关费用及60天后争议处理与法律费用条款适用；所有争议以加州Riverside County法院管辖。

LanguageEnglish

CategoryForms

FormatPDF

Pages1

AccessFree to download

Customer and Card Details

Customer/Business info

Card information and billing address

Authorization and Charges

Invoice authorization (SLS number and amount)

Subtotal, transaction fee, total charge

Expired/Declined and Dispute Terms

Update deadlines and fees

Chargebacks and legal venue

Agreement and signature

CREDIT CARD AUTHORIZATION FORM Customer/ Business Name: Date: / / Please keep this card on file for future use: Yes □ No □ Auto Charge all Invoices Yes □ No □ Email for Approval: □ Email: Phone: ( ) - ***I understand no response within 5 days of requested approval, the below card will be charged*** Credit Card Account Number CVV/CSV/MC Number: (Visa/MC 3 digits on back on card-Amex 4 digit on front of card) Name on the Card: Exp Date: Month Year Card Holders Billing Address: Zip Code: Email Receipt to: | Authorize to pay Invoice \# (SLS Number) | Amount | | --- | --- | | | | | Sub Total | | | plus 3.5% Transaction Fee *will automatically be added at processing | | | Total Charge Including Transaction fee | | Expired/ Declined Credit Cards: New/ Updated card information must be submitted within 15 days or will be subject to a 1 ½% fee and continue to be charged on monthly basis until payment is received. Charge-backs will be subject to a $30 fee. If payment is not received after 60 days on an expired, declined or chargeback transaction, you will be taken to small claims court and late fees, collection costs, court costs and any attorney fees will be added to unpaid invoices. All orders are subject to additional charges not included in original quote based on assessorial charges incurred during shipment or at time of delivery or any cancellation charges, including any and all costs incurred by, or charged to SLS Freight LLC. The venue and jurisdiction for any dispute arising out of this agreement, and/or relationship between SLS Freight LLC and the other parties to this agreement, including but not limited to, disputes over individual shipments, shall be brought in the Riverside County Court, CA. The undersigned hereby expressly agree(s) that all shipments tendered shall be subject to Terms and Conditions [listed at www.slsfreight.com, which are fully incorporated into this Agreement. I /We have read this Credit Policy, and agree](listed at www.slsfreight.com, which are fully incorporated into this Agreement. I /We have read this Credit Policy, and agree)[ ](listed at www.slsfreight.com, which are fully incorporated into this Agreement. I /We have read this Credit Policy, and agree)[to abide by its](to abide by its terms.)[ terms.](to abide by its terms.) Print Name:_______________________________________________ Title:_______________________________________ Signature:_______________________________________________ Date:___________/____________/_______________ Send completed authorization form via email to [slsaccounting@slsfreight.com](slsaccounting@slsfreight.com) [SLS Freight LLC 1761 3](SLS Freight LLC 1761 3rd St)[rd](SLS Freight LLC 1761 3rd St)[ St](SLS Freight LLC 1761 3rd St)., [Suite 201](Suite 201), [Norco CA 92860 Phone 888-320-5585](Norco CA 92860 Phone 888-320-5585)

FAQs

表单主要用于做什么授权？

用于授权信用卡支付SLS Freight LLC的发票。需填写卡信息、发票号（SLS number）与授权金额，并同意相关付款与审批条款。

审批请求后如果没有回复会发生什么？

若在请求审批后5天内无回复，表单声明将对所填信用卡进行扣款。

如果信用卡过期或被拒付，需在多久内更新？

需要在15天内提交新的或更新的卡信息，否则将可能被收取1.5%费用，并按月继续扣款，直到收到付款。

Sep 17, 2026

Upload by Mary Man