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What is a credit card authorization form?

A credit card authorization form is a document, signed by a cardholder, that grants a merchant permission to charge their credit card for a one time or recurring payments during a period of time as written in that document.


Please complete all fields. You may cancel this authorization at any time by contacting us. This authorization will remain in effect until cancelled.

CC Authorization
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Thank You

*Credit Card Authorization Signature Disclaimer

By providing your signature below, you:

  • Authorize Use of Credit Card Information: Confirm that you are the authorized cardholder or have been duly authorized by the cardholder to use the credit card details provided. You authorize Sanico USA to charge the credit card for the specified services or products.

  • Consent to Recurring Charges (if applicable): If you select the 'Recurring Charges' option, you authorize Sanico USA to charge the provided credit card for future services or products on a recurring basis as specified in the agreement or until you provide a notice to cancel this authorization.

  • Acknowledge and Agree to Terms: Acknowledge that you have read, understood, and agreed to the terms and conditions associated with the transaction, as outlined on our website and in any related agreements or documentation.

  • Confirm Accuracy of Information: Certify that all information provided in connection with this Credit Card Authorization is accurate, complete, and current. You agree to promptly update any changes to this information.

  • Understand Fraudulent Use Consequences: Understand that fraudulent use of the credit card information on this form can result in legal action and the notification of relevant authorities.

  • Electronic Signature Agreement: Agree that your electronic signature, whether digital or encrypted, is legally binding and equivalent to your handwritten signature.

Please ensure that all information is complete and accurate before submitting the form. If you have any questions or concerns regarding this authorization, please contact us at

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