Danielsville, GA · Madison County
Recurring Credit Card Charge Authorization Form
Danielsville customers use this form to authorize recurring credit card charges for listed accounts and provide contact, card, and billing information.
What this form is
This form authorizes the City of Danielsville to make recurring charges to the credit card listed and, if necessary, correct transactions credited or debited in error. It asks for the cardholder’s contact and billing details, card information, account numbers or an option to cover all accounts, and an optional dollar limit. The authorization remains in effect until the city receives written cancellation.
Who needs it
Customers who want to authorize recurring credit card charges for one or more listed accounts should complete and sign this form.
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; it does not identify any notarized attachment or sworn step.
How to submit this form
- 1
Download The Form
Download the Recurring Credit Card Charge Authorization Form.
- 2
Complete The Form
Enter the requested contact, credit card, billing, and account details, and indicate whether the authorization covers all accounts.
- 3
Gather Account Information
Attach a list of accounts if you need more space than the form provides.
- 4
Sign And Submit
Sign and date the form, then submit it to the city department named on the form.
Frequently asked questions
- Do I need a notary for the Recurring Credit Card Charge Authorization Form?
- No. The form calls for a signature and effective date, but it does not require notarization or identify a notarized attachment or sworn step.
- How do I submit the Recurring Credit Card Charge Authorization Form?
- Submit it to the city department named on the form; check the city website for current contact details.
- What information does the authorization form ask for?
- It asks for the cardholder’s name, address, phone number, email, card and billing details, and account numbers or an option to cover all accounts.
- Can I set a dollar limit on recurring charges?
- Yes. The form provides an optional dollar limit. It says charges exceeding that limit cannot be processed electronically and must be paid manually by cash or check.
Need something notarized?
This Recurring Credit Card Charge Authorization Form doesn’t need a notary — but if you have another Danielsville form that does, a commissioned online notary can help.