Credit Card Auth Form


Reference: SPARK FACTORY
Name on Card:

Email:

Billing Address:

City, State, Zip Code:

Card Number:

CVV:

Expiration:

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 for fees relating to Spark Factory's services. By accepting this authorization I agree to pay all service fees without offset or refusal.

Leave this empty:


Signature Certificate
Document name: Credit Card Auth Form
Unique Document ID: 6b67eb88f874309e6efe38135e04a6566b8cc33a
Timestamp Audit
April 1, 2021 3:00 pm EDTCredit Card Auth Form Uploaded by Scott Aadal - [email protected] IP 70.174.19.138
Audit trial Qr code
This audit trail report provides a detailed record of the online activity and events recorded for this document.
https://sparkfactory.io/
Audit Trail Serial# 8bb64a83eb07b155b4fddd92a5e458e0