Credit Card Authorization Form

By signing this form you give The Furniture Taxi® permission to debit your account for the amount indicated below on or after the date specified on this form. This is permission to charge your account for services rendered and provided by The Furniture Taxi®, to include but not limited to: Deposits, Moving, Packing, Loading/Unloading, Delivery, Storage and Supplies/Materials. As a reminder, The Furniture Taxi® adds a 3% convenience fee for all credit card transactions.
Please complete the information below:

I, , authorize The Furniture Taxi® to charge my credit card account indicated below for the amount of $, and I would like to include a tip (optional) in the amount of $on or after .

The collective total will incur a 3% convenience fee.
This payment is for the services and/or products provided to me by The Furniture Taxi®.

Cardholder Name:

Card Number:

Expiration Date (mm/yy):

CVV (Security Digits):

Billing Street Address:

Apt/Suite: Billing Zip Code:

Phone # : Email:

I authorize The Furniture Taxi® to charge the credit card indicated on this authorization form according to the terms outlined above. I understand that this authorization will remain in effect until I cancel it in writing. If the above noted payment date falls on a weekend or holiday, I understand that the payment may be executed on the next business day. For a full deposit refund, cancellations must be made in writing to, 48 hours prior to my scheduled service date. Any cancellations not made at least 48 hours in advance will result in a no-refund policy. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company.

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