credit card change
I hereby authorize SeniorLeads to update the credit card on file for the billing of services rendered according to the terms of the service agreement, to the following:
Card Holder Name: Credit Card number: Expiration: 3-digit Security Code on back of card: Billing Street Address: City: State: Zip:
I acknowledge that the terms and conditions put forth in the initial Service Agreement remain the same and will apply to the updated credit card information, provided above.
Select one of the checkboxes below:
WE WILL USE THIS NEW CARD FOR ANY OUTSTANDING BALANCE AND FOR CHARGES GOING FORWARD. IF YOUR ACCOUNT HAD BEEN SUSPENDED, WE WILL REACTIVATE YOUR ACCOUNT UNLESS YOU CHECK BELOW TO CLOSE YOUR ACCOUNT
ALLOW ONE FULL BUSINESS DAY FOR THE CHANGE TO BECOME EFFECTIVE
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Document Name: credit card change
Agree & Sign