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Credit Card Authorization Form for Transportation Services. Credit Card Payments - Visa, Master Card, American Express, and Discover are accepted and processed by GreenRide.net. To use your credit card, please. 1. Fill in the blanks online 2. Print out and sign this Form, authorizing the charge to your card account. 3. Fax or email-scan this Form to the addresses shown below. Fax: (888) 461-4825 Email: Creditcard@greenride.net Credit Card Authorization Form: I authorize GreenRide.net to charge my credit card for Transportation services rendered. I understand that the charge reflected on my Credit Card. Statement will be in the name "GreenRide.net” or "LIMAXI LLC". My authorized signature on this form will be valid for any future, ongoing charges that I may choose to charge through Green Ride or LIMAXI LLC. Furthermore, I authorize to be charged for waiting time charges if any, or any additional charges related to services rendered. My authorization information is as follows: Exact name on card: Type of card: Card number: Expiration date: Credit card verification number: Initial amount authorized: US$ What is this 20% Driver's gratuity is extra Your credit card billing address: Billing zip code: City/State/Zip: Credit Card Billing Billing Phone Number: E-mail: Today's date: Contact Phone Number: Instructions: |
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and parking fees are additional 20% gratuity is suggested for all rates Additional waiting time charges if any will apply by the minute For non airport services Up to 4 people can ride for the same rate ©2003-2009, GreenRide.net, LIMAXI LLC, All rights reserved TCP21653P  |
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