on a [one-time or recurring basis] as payment
I certify that I am the owner of the credit card indicated above and will not dispute the scheduled payment with my bank/credit card company; provided that the transactions match with the terms described on this authorization form.
For recurring transactions, I understand that my information will be saved to file for future transactions on my account and authorization will remain in effect until I formally request cancellation.
24640 JOHN R HAZEL PARK, MI 48030 Phone:248-542-1444 FAX: 248-542-2384 Email:[email protected]
674 S. LAPEER LAKE ORION, MI 48362 Phone:248-824-9932 FAX: 248-814-9152 Email:[email protected]
I HEARBY AUTHORIZE THIS CREDIT INVESTIGATION DEEMED NECESSARY IN CONJUNCTION WITH THIS REQUEST.
THANK YOU FOR CONSIDERING GNE AS ONE OF YOUR CREDIT SOURCES.
PLEASE NOTE THAT ALL ACCOUNTS HAVE 30 DAYS FROM THE DATE OF INVOICE TO PAY. OVER 60 DAYS PAST DUE WILL BE IMMEDIATELY PLACED ON C.O.D. IF IT BECOMES NECESSARY TO PLACE THIS ACCOUNT IN THE HANDS OF OUR COLLECTIONS DEPARTMENT IN ORDER TO ENFORCE COLLECTION BY SUIT OR OTHERWISE, YOU WILL BE REQUIRED TO PAY ALL ATTORNEY FEES AND ADDITIONAL COSTS, INCLUDING COURT COSTS INCURRED AS EXPENDED.
I/WE FULLY UNDERSTAND THE TERMS OF PAYMENT. I/WE FURTHER AGREE TO PAY ALL ATTORNEY FEES AND ANY OTHER ADDITIONAL COST INCLUDING COURT COSTS INCURRED IF IT IS NECESSARY TO REFER THIS ACCOUNT TO OUR ATTORNEY IN ORDER TO ENFORCE COLLECTION.
