Authorization for Credit Card Use

All information herein will remain confidential

Name on Card:  

Billing Address:  
Credit Card Type: 
Credit Card Number:  
Expiration Date:  
Card Identification (CVV) Number: (last 3 digits located on the back of the credit card)

I hereby authorize Santa Monica Flyers, Inc. (SMF) to charge the above credit card any time I incur a balance on my customer/renter account, that I don’t pay myself, upon the completion of my flight or ground school lesson. I agree to pay balances owed, with the above credit card, for flight instruction, airplane rental, landing fees, pilot supplies, or any other charge I incur, as a result of services or goods I have acquired at SMF. I agree to pay for this purchase in accordance with the issuing bank cardholder agreement. I also understand billing disputes will be resolved within 30 days of my notifying SMF in writing and that any refund issued to resolve billing disputes, will be issued via check.

Cardholder – Signature & Date

Signature:   Date:
Print Name:  

Leave this empty:

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Signature Certificate
Document name: Authorization for Credit Card Use
lock iconUnique Document ID: d91ed1b450ce0a1e9fc959d0cea447bd070a5fe6
Timestamp Audit
September 15, 2020 6:33 pm PSTAuthorization for Credit Card Use Uploaded by Santa Monica Flyers - [email protected] IP