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    Authorization To Use and Charge Credit Card: SMC Skyway Corporation

    Uploaded by

    Darryl Coleta
    This document authorizes an individual ("Subscriber") to use a credit card for replenishing their RFID toll account. It provides details of the credit card holder and subscriber, as well as the auto-replenishment threshold amount. The credit card holder confirms that the information is voluntarily disclosed, the arrangement can be terminated in writing, and it is their responsibility to update credit card details before expiration to avoid termination. Copies of the credit card front and valid IDs of the credit card holder and subscriber must be attached.

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    © All Rights Reserved
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    Authorization To Use and Charge Credit Card: SMC Skyway Corporation

    Uploaded by

    Darryl Coleta
    426 views1 page
    This document authorizes an individual ("Subscriber") to use a credit card for replenishing their RFID toll account. It provides details of the credit card holder and subscriber, as well as the auto-replenishment threshold amount. The credit card holder confirms that the information is voluntarily disclosed, the arrangement can be terminated in writing, and it is their responsibility to update credit card details before expiration to avoid termination. Copies of the credit card front and valid IDs of the credit card holder and subscriber must be attached.

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    auth letter

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    c61f17d17d7b98e20c2fddc00b3ce464583603321

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    This document authorizes an individual ("Subscriber") to use a credit card for replenishing their RFID toll account. It provides details of the credit card holder and subscriber, as well as the auto-replenishment threshold amount. The credit card holder confirms that the information is voluntarily disclosed, the arrangement can be terminated in writing, and it is their responsibility to update credit card details before expiration to avoid termination. Copies of the credit card front and valid IDs of the credit card holder and subscriber must be attached.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    426 views1 page

    Authorization To Use and Charge Credit Card: SMC Skyway Corporation

    Uploaded by

    Darryl Coleta
    This document authorizes an individual ("Subscriber") to use a credit card for replenishing their RFID toll account. It provides details of the credit card holder and subscriber, as well as the auto-replenishment threshold amount. The credit card holder confirms that the information is voluntarily disclosed, the arrangement can be terminated in writing, and it is their responsibility to update credit card details before expiration to avoid termination. Copies of the credit card front and valid IDs of the credit card holder and subscriber must be attached.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    AUTHORIZATION TO USE AND CHARGE CREDIT

    CARD

    Date

    SMC Skyway Corporation


    11F San Miguel Properties Centre, 7 St. Francis St Ortigas Center,
    Wack Wack Greenhills, Mandaluyong City 1555

    This is to authorize (Mr./Ms.) _________________________________________ ("Subscriber") to use, and for


    SMC Skyway Corporation and its Authorized Credit Card Bank Host (“Provider”) to charge the Credit Card for the
    replenishment of the RFID Account based on the details provided below:

    CREDIT CARD HOLDER'S DETAILS SUBSCRIBER'S DETAILS

    Card Holder's Name Name

    Credit Card Number RFID Account No.

    Card Type 0Mastercard 0Visa Plate No.

    Issuing Bank Tel No./ Mobile No.

    Expiry Date Email Address

    Auto Replenishment 0500 (Default) 01,000 03,000 05,000 Threshold Amount 0500 (Default) 01,000 03,000 05,000
    Amount Other Amount (Please specify) ______ Other Amount (Please specify) ______

    Further thereto, we hereby confirm that:


    1) The above information for the Prepaid Toll replenishment is voluntarily disclosed.
    2) This Arrangement shall be on a continuing basis unless terminated in writing by the Credit Card Holder,
    Subscriber, and/or by SMC Skyway Corporation.
    3) We are responsible in updating the credit card details by submitting an updated Authorization To Use and
    Charge Credit Card Form with the RFID Customer Service Center within two (2) months prior to the credit
    card expiration date to avoid termination of this Arrangement.
    4) In case a credit card is declined in an automatic replenishment transaction, this Authorization shall be
    terminated automatically without prior notice.

    Attached hereto to support this Authorization are a photocopy each of the front of the credit card and of the
    respective valid IDs (bearing the photo and signature) of the Credit Card Holder and of the Subscriber.

    ______
    Credit Card Holder’s Printed Name & Signature Date Subscriber's Printed Name & Signature Date

    TO BE FILLED OUT BY AUTOSWEEP RFID PERSONNEL


    Received By Processed By
    Date Date
    Branch/Location

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