Authorized to Charge Update

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Authorized to Charge Update

Keeping your account safe and secure is our top priority. Please use the form below to make changes to the Authorized to Charge list associated with your Builders Supply account. By keeping your Authorized to Charge list updated and accurate, we can prevent unauthorized charges and fraud.

Account Name or Number*
Please provide the account name or number that shows on your invoices or statements.
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Authorized to Charge: Add Names

Please provide the first and last name of the person you are authorizing to charge on your account.
Authorized to Charge: Remove Names

Please provide the first and last name of the person you are removing from your authorized to charge list.
Please indicate the most appropriate response:
- The names I am providing today are the only people authorized to charge on my account. All other names must be removed.
- The names I am providing today are in addition to the authorized to charge list already established on my account.
- Remove all authorized to charge names besides myself, the owner.
Authorized to Charge Agreement*
I agree
By submitting this change, I acknowledge the changes on this form and assume full responsibility for said changes. I agree that any further changes to my account’s authorized to charge list will have to be resubmitted.
Signature of Account Owner*
First Last
Date*
MM slash DD slash YYYY
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