Credit Card Authorization - Builders Supply

Home Credit Card Authorization

Prepay Credit Card Authorization

Here’s How Recurring Payments Work: You authorize regularly scheduled charges to your Visa, MasterCard, Discover, or American Express card. You will be charged for each invoice for the total amount due for that invoice. The charge will appear on your credit card statement. You agree that no prior-notification will be provided and that this authorization will remain in effect until you as the cardholder cancels this authorization form. Your invoice will be mailed to account holder address for this transaction.

I hereby authorize Builders Supply Co., Inc. to charge my stated credit/debit card for each order made on my behalf at time of purchase.

Prepay Authorization

Name*
First Last
Business Name
Your account will be setup using the business name provided. Leave blank if you wish to use the name provided above instead.
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone
Delivery method for invoices:*
- Email
- Mail
Card Type*
Cardholder Name*
First Last
Card Number*
Please enter the 16 digit number using dashes.
Expiration Date*
MM/YYYY
CVV*
3/4 digit security code
Terms & Conditions*
I agree to the terms and conditions
I authorize the above named business to charge the credit card indicated in this authorization form according to the terms outlined above. If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify the business in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. This payment authorization is for the type of bill indicated above. I certify that I am an authorized user of this credit card and that I will not dispute the scheduled payments with my credit card company provided the transactions correspond to the terms indicated in this authorization form.
Signature*
First Last
Date*
MM slash DD slash YYYY