CC Form - Moving Company

 - NTL OF NYC

Credit Card Information

This transaction will be processed payment upon completion of the move. By signing below, I authorize [Moving Company Name] to charge the agreed amount to my credit card. I agree to pay the total amount cost of move per the card issuer agreement.I acknowledge that this is a binding contract for moving services and my credit card will be charged the amount agreed upon completion of the move, regardless of any disputes. No refunds will be issued after the move is completed, except in cases where [Moving Company Name] fails to fulfill its obligations under the moving contract. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company, so long as the transaction corresponds to the terms indicated in this form. I understand that [Moving Company Name] may disclose information about me and my move to the credit card issuer if necessary to resolve a dispute or chargeback related to this transaction. This agreement shall be governed by and construed in accordance with the laws of the State of {Your State} and FMCSA regulations 49 CFR 375 related to household goods transportation.

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