Credit Card Authorization Form

To assist us in deterring the fraudulent use of credit cards, please fax an enlarged and lightened copy of the FRONT AND BACK OF YOUR CREDIT CARD AND DRIVER'S LICENSE, along with the authorization form below, to 510.733.9320 .

E Mail Address:*

Confirmation Number: *

Date of Service:*

Name (as it appears on credit card):*

Billing Address (where credit card bill is sent):*

City:

State:

Zip:

Telephone numbers:

Home:

Work:

ext:

Fax:

Cell:

CREDIT CARD INFORMATION

Card Number:*

Exp. Date:*

PLEASE CHARGE CREDIT CARD AS FOLLOWS:*

I authorize AngelLimo.com Service DBA AngelLimo.com to charge the credit card specified above the full amount of the service. In accordance with the terms and conditions between AngelLimo.com and the undersigned, I fully understand AngelLimo.com 's Cancellation Policy. I authorize AngelLimo.com to process all charges accordingly.
I would like to establish a retail credit card account and authorize AngelLimo.com Service DBA AngelLimo.com to process any charges for all future service. I, the undersigned, authorize AngelLimo.com Service DBA AngelLimo.com to charge the above referenced credit card for transportation and related services which may be rendered through AngelLimo.com and/or its affiliates. In accordance with the terms and conditions between AngelLimo.com and the undersigned, I fully understand AngelLimo.com Cancellation Policy. I authorize Service DBA AngelLimo.com to process all charges accordingly.

Reservations: 866-803-9898

925-803-9898

Credit Card Authorization Form

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