Joni Mueller, PLS, CLA

Your Virtual Legal Secretary

You are here: Home / Recurring Credit Card Authorization Agreement

Recurring Credit Card Authorization Agreement

Available for Download

Download, complete, and return the recurring credit card authorization agreement above (in Word or PDF format) or simply fill out and sign the online form. Once you complete the form online, a PDF will be emailed to you.

Recurring Credit Card Payment Authorization

  • You authorize regularly scheduled charges to your credit card. You will be charged the amount indicated below each billing period. A receipt for each payment will be provided to you and the charge will appear on your credit card statement. You agree that no prior notification will be provided unless the date or amount changes, in which case you will receive notice from us at least 10 days prior to the payment being collected.
  • authorize JONI MUELLER, PS, CLA, to charge my Credit Card indicated below in the amount of (choose package below)
    Select the package below for which you are authorizing recurring billing.
  • on the first day of each month, beginning on
  • Date Format: MM slash DD slash YYYY

  • Billing Information

  • Credit Card Information

  • American Express
    Discover
    MasterCard
    Visa
      
  • I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify JONI MUELLER, PLS, CLA, in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. I acknowledge that the origination of Credit Card transactions to my account must comply with the provisions of U.S. law. I certify that I am an authorized user of this Credit Card and will not dispute these scheduled transactions; so long as the transactions correspond to the terms indicated in this authorization form.
  • Date Format: MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.
Request Legal Support

Grab My Newsletter

Grab my newsletter featuring tips and tricks for working with Microsoft Word and formatting and styling briefs within the court system.

Contact Me

Launching June 1, 2020!

I am excited to launch my new virtual legal secretarial services web site on June 1, 2020. Sign up for my newsletter to get advance notices and tips and tricks about brief formatting and working with Microsoft Word and Adobe PDF.