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Credit Card Authorization Form for Rachel’s Big City Transportation of RI Any questions, please call 401-219-9187

Credit Card Authorization Details

First Name(*)
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Last Name(*)
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Credit Card # / Amount to Be Billed / Date(s) of Travel(*)
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Email(*)
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Expiration Date(*)
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Security Code(*)
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Billing Zip Code(*)
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I authorize Rachel's Big City Transportation of Rhode Island to charge the credit card indicated in this credit card authorization form according to the terms outlined above. This payment authorization is for transportation service, for the amount indicated above. By typing my name below on this credit card authorization form, 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.

Name(*)
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Do you authorize Rachel Carvalho to charge your credit card for the amount entered above?
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(*)

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