Authorizatrion for Credit Card & ACH Payments for Services & Reocurring Payments


Reference: SPARK FACTORY

AMOUNT: Varies based on usage & service plan
Name on Card:
 
Email:
 
Billing Address:
 
City, State, Zip Code:
 
Card Number:
 
CVV:

Expiration:
 

Bank Information

Bank Name:           
Holder Name:       
Routing Number:   

Account Number:  
Account Number:  
Verififcation

Upload copy of Credit Card Image:


Upload Drivers License: 

I understand that a non-sufficient funds (NSF) fee may be charged in the maximum amount allowed by state by my financial institution. I authorize the debit of this fee in full and acknowledge that Spark Factory and/or Pilates Web Co will not be responsible for any fees incurred by my financial institution.

I (We), authorize my (our) credit card/ACH to be charged weekly/monthly/quarterly/yearly for fees relating to Spark Factory's services. By accepting this authorization I  agree to pay all service fees without offset or refusal. All invoices are subject to late fees, interest, and legal costs. Additionally I (we) agree to Spark Factory's terms and conditions. Spark Factory billling occurs weekly, monthly, quarterly and/or yearly along with any 'other' services (indicated on each invoice). Payment is due immediately or before the due date. Any accounts that are deliquent more than three () business days may be suspended without notification. 

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Document name: Authorizatrion for Credit Card & ACH Payments for Services & Reocurring Payments
lock iconUnique Document ID: c676409f5bcd80d21f6f78954ea197d3d7559f6f
Timestamp Audit
January 5, 2021 1:01 pm EDTAuthorizatrion for Credit Card & ACH Payments for Services & Reocurring Payments Uploaded by Scott Aadal - scott@sparkfactory.io IP 70.174.19.138