Millbrae, CA · San Mateo County
One Time Credit Card Authorization
Cardholders use this form to authorize the City of Millbrae to charge a credit card once for a listed city service, fee, or account.
What this form is
This one-time authorization lets the City of Millbrae charge a credit card for a listed business license, utility account, or application, permit, or project fee. It states that the authorization applies to one transaction only and that the city will not make future charges under it. The form requests the charge purpose and reference details, card and billing information, amount, phone authorization choice, and the cardholder’s signature and date.
Who needs it
A cardholder or business representative paying a listed Millbrae charge by credit card uses this form to authorize one transaction.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This form is signed and dated without a notary; the document lists no sworn attachment or notarized step.
How to submit this form
- 1
Download The Form
Download the One Time Credit Card Authorization PDF.
- 2
Complete The Form
Select the charge purpose and provide the requested account or reference details, amount, card information, and cardholder information.
- 3
Sign And Date
The cardholder authorizes the one-time charge by signing and dating the form.
- 4
Submit To The City
Submit the completed form to the city department named on it; check the city website for current contact details.
Frequently asked questions
- What does the One Time Credit Card Authorization do?
- It authorizes the City of Millbrae to charge a credit card once for a listed business license, utility account, or application, permit, or project fee.
- Do I need a notary for the One Time Credit Card Authorization?
- No. The form is signed and dated without a notary, and it lists no sworn attachment or notarized step.
- How do I submit the One Time Credit Card Authorization?
- The form does not state how to submit it. Submit it to the city department named on the form and check the city website for current contact details.
Need something notarized?
This One Time Credit Card Authorization doesn’t need a notary — but if you have another Millbrae form that does, a commissioned online notary can help.