Credit Card Authorization Form

Victory Production Rentals LLC (Kentucky) Credit Card Authorization Form

Please complete all sections and sign this application.

All Customers must provide Credit Card (not a Debit Card) information for a security deposit. A hold for the value of the rental will be placed and returned upon successful return.

Victory Production Rentals LLC charges a 3.9% fee for all credit card transactions.ur text

Company Name

Authorized Amount

First name

Last name

Phone

Credit Card Type

Visa

Mastercard

American Express

Credit Card Number

Expiration Date

Month

Day

Year

CVV

Multi-line address

Country/Region

Address

Address - line 2

City

Zip / Postal code

I authorize Victory Production Rentals LLC. to charge the credit card listed for the authorized amount.

I further authorize Victory Production Rentals LLC to charge the credit card on file as needed to cover additional rental charges and fees including but not limited to any loss or damage of rental equipment.

Signature

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Position

Date and time

Month

Day

Year

Time

HoursMinutes