Credit Card Authorization Form

After you complete this Authorization Form one of our staff will process the payment with your card as soon as possible.

Name on Card *
Name on Card
Address Line 1/City/State/ZipCode
Expiration Date *
Expiration Date
Be sure you enter the month and year. The Day is not important.
$
Enter your Credit Card type
Authorize *
Authorize Visual Media Group LLC / DBA Saul Padua Photography to charge the following items/invoices to my credit card. Applicable tax may not be included in the stated dollar amount. These charges will be added if applicable. Being the cardholder or Corporate Officer, by signing below I understand and agree to the terms set forth in this agreement, agree to pay, and specifcally authorize to charge my credit card, for the services provided. I further agree that in the event my credit card becomes invalid, I will provide a new valid credit card upon request, to be charged for the payment of any outstanding balances owed.
Enter you invoice number