Location (required) ---PhoenixGilbertChandlerDeer ValleyGlendale I Accept (required) I authorize the above indicated facility to keep my signature on file and to charge my credit card account, listed below, in the amount of $ (Rent + Taxes) on the first day of the month, beginning on _____________ and ending when I vacate my unit(s) or cancel this agreement. I understand that this form is valid until I cancel this authorization, ten (10) days prior to vacating, through written notice to the above indicated facility. I Accept (required) I authorize the above indicated facility to keep my signature on file and to charge my credit card account in the event I may call and ask the management to do so. I understand that management cannot charge my card for accounts over thirty (30) days past due or upon vacating my unit. Unit Number(s) Customer Name Cardholder's Name If Different Card Type VisaMasterCardAmex Last Four Digits on Card Expiration Date Cardholder's Signature Date Δ
---PhoenixGilbertChandlerDeer ValleyGlendale
I Accept (required) I authorize the above indicated facility to keep my signature on file and to charge my credit card account, listed below, in the amount of $ (Rent + Taxes) on the first day of the month, beginning on _____________ and ending when I vacate my unit(s) or cancel this agreement. I understand that this form is valid until I cancel this authorization, ten (10) days prior to vacating, through written notice to the above indicated facility. I Accept (required) I authorize the above indicated facility to keep my signature on file and to charge my credit card account in the event I may call and ask the management to do so. I understand that management cannot charge my card for accounts over thirty (30) days past due or upon vacating my unit. Unit Number(s) Customer Name Cardholder's Name If Different Card Type VisaMasterCardAmex Last Four Digits on Card Expiration Date Cardholder's Signature Date Δ
I authorize the above indicated facility to keep my signature on file and to charge my credit card account, listed below, in the amount of $ (Rent + Taxes) on the first day of the month, beginning on _____________ and ending when I vacate my unit(s) or cancel this agreement. I understand that this form is valid until I cancel this authorization, ten (10) days prior to vacating, through written notice to the above indicated facility.
I Accept (required) I authorize the above indicated facility to keep my signature on file and to charge my credit card account in the event I may call and ask the management to do so. I understand that management cannot charge my card for accounts over thirty (30) days past due or upon vacating my unit.
Unit Number(s)
Customer Name
Cardholder's Name If Different
Card Type VisaMasterCardAmex
Last Four Digits on Card
Expiration Date
Cardholder's Signature
Date
Δ
