Credit Card Form

Only required if you chose AUTOMATIC PAYMENTS

Automatic Credit Card Billing Authorization Form

If you would like to enjoy the convenience of automatic billing, simply complete the Credit Card Information section below and sign the form. All requested information is required. Upon approval, we will automatically bill your credit card for the amount indicated and your total charges will appear on your monthly credit card statement. You may cancel this automatic billing authorization at any time by contacting us.

PLEASE NOTE THIS IS THE AUTHORIZATION FORM ONLY
YOU MUST CALL 303-431-4297
AND PROVIDE YOUR CREDIT CARD INFORMATION THAT WE ENTER DIRECTLY INTO OUR SECURE ACCOUNTING SYSTEM BEFORE YOUR CARD WILL BE CHARGED.


My unit is stored with:*
Name as it appears on card:*
Phone:*
-

I authorize Aa Adults Toy Storage, LLC. or Colorado Signal Storage to automatically bill the card on file as specified:

Amount:*
 $ 
How Often:*
Start Billing on Date:*
We accept:*

Upon completion of this form
You must call 303-431-4297 during business hours Mountain time
PROVIDE YOUR CREDIT CARD INFORMATION THAT WE ENTER DIRECTLY INTO OUR SECURE ACCOUNTING SYSTEM BEFORE YOUR CARD WILL BE CHARGED.

By entering your typed name below and pressing the "Submit" button you are adopting this as your electronic signature and do hereby agree to the terms and conditions as set forth herein. 

Card holders electronic signature:*
Date:*
Billing E-mail:*

Please Note:
You will most likely find your copy of this in your spam or junk mail box.