Credit Card Authorization Form

Updated:

A credit card authorization form is written permission to charge a card. The cardholder signs it to approve a single payment or a series of payments to a named business. Hotels, caterers, rental companies and service providers use it to bill clients remotely.

Create your own with the free template on this page, then download it, print it, and keep a signed copy.

Credit card authorization form preview

Create a free high-quality Credit Card Authorization Form online now!

Build Your Document

Answer a few simple questions to make your document in minutes

Save and Print

Save progress and finish on any device, download and print anytime

Sign and Use

Your valid, lawyer-approved document is ready

What Is a Credit Card Authorization Form?

People also call it a CC authorization form, a card authorization form, a credit card auth form or, in British spelling, a credit card authorisation form. The form names the card, the cardholder, the business, the amount and the timing. It ends with the cardholder’s signature and the date.

The form is the customer’s written consent. It is not the electronic approval a card network runs at checkout, and it is not a payment: the business charges the card later, on the terms the form sets out.

Who Needs a Card Authorization Form

A card authorization form suits any business that charges a customer’s card when the customer is not there to pay, such as a caterer billing a regular client, a hotel taking a deposit, or a rental company holding a card against damage.

Typical users include:

  • Caterers and restaurants that deliver lunch to the same office again and again
  • Equipment rental companies that hold a card until the item comes back
  • Hotels that take a deposit or bill a guest’s stay to another person’s card
  • Gyms, clubs and subscription services that bill members every month
  • Agencies, consultants and tutors that take a deposit for later work
  • Charities that collect regular donations

Cardholders use the same paperwork when someone else pays for them, for example a parent covering a student’s booking or a company paying for an employee’s stay. Many hotels have their own version, such as this hotel card authorization form.

How Businesses Use Card Authorization Forms

Businesses use a card authorization form to charge a customer’s card without the customer being present and to keep written proof that the customer agreed to the charges, which the business can submit as evidence if a buyer later disputes a payment with the card issuer. The card network’s dispute rules decide the outcome.

It also gives sellers evidence to answer chargeback fraud. This happens when a buyer pays online with a card, then asks the card issuer for a chargeback after receiving the goods or services. A dispute can freeze the money in question while the business gathers the paperwork to answer it.

For repeat billing the form saves time as well: the business takes the card details once instead of asking for them before every charge, and the customer has a signed copy of the charges and schedule agreed.

Collect the Customer’s Card and Billing Details

Once the buyer and seller agree on the purchase terms, the business sends the form and asks for the cardholder’s name, card number, expiration date and billing address, the details a payment processor needs to run the charge.

Choose a Single or Recurring Charge

Mark the form for a single charge, such as a purchase or deposit, or as a recurring charge for payments that repeat, and fill in the amount and the schedule before the customer signs.

Get the Cardholder’s Signature

Have the cardholder sign and date the form to confirm consent to the charges it describes, then check that the name and card on the form match the card you are about to charge.

Store the Signed Form Securely

Black out or destroy the card security code (CVV) on the form once the charge is authorized, and keep the rest of the signed form only as long as the authorization runs and any dispute may need it.

Minnesota law bars a business there that accepts cards from keeping the security code after the charge is authorized (Minn. Stat. 325E.64); other states set their own rules.

Limit access to the people who process payments, and follow your payment processor’s rules for storing card numbers.

Types of Card Authorization Forms: Single Charge, Recurring and ACH

A card authorization form covers either a single charge or a series of repeating charges, and a related ACH form gives the same kind of permission for payments drawn from a bank account instead of a card.

The free template on this page covers both: you pick one-time or recurring, then choose a bank or card payment method. Hotel chains’ own versions are linked under Specific Credit Card Authorization Forms near the top of this page.

What to Include in a Card Authorization Form

A complete form records who is paying, which card is used, what the cardholder agrees to, and when. Compare any form template against the list below before you send it out.

  1. Card details: The card type (debit or credit), the cardholder’s name, the card number, the expiration date and the billing address.
  2. Card security code (CSC): A 3- or 4-digit security code is usually found on the back of the card (Visa, MasterCard, and Discover) or the front (American Express).
  3. Business details: The name of the business or service provider that will charge the card, and how to reach it.
  4. Authorization statement: Specific language indicating that the customer authorizes the seller to charge the provided card for the transaction(s).
  5. Authorization type: A single charge or recurring payments.
  6. Goods or services: A short description of what the customer is paying for.
  7. Amount: The sum the cardholder approves for each charge, or the most the business may charge.
  8. Dates: The charge date, or the billing day and how often the charge repeats.
  9. Cardholder’s name and signature: The printed name and signature that confirm consent to the charges.
  10. Date signed: The day the cardholder signs the form.

Leave out anything the charge does not need, such as a PIN or an online banking password.

How to Fill Out a Credit Card Authorization Form

To fill out a credit card authorization form, choose the charge type, enter the charge details, add your billing and payment information, then read the terms, sign, print your name and date the form.

Choose the Authorization Type

Select either the “Recurring Charge” or “One (1) Time Charge” option, depending on whether you want to authorize regularly scheduled monthly charges or a single charge.

Complete the Authorization Details

Fill in the fields for the type you chose, so the business knows who is paying, who is charging, how much, when, how often and for what:

  • Your full name
  • The merchant’s name
  • The charge amount
  • The date (or day of each billing period for recurring charges)
  • The frequency of the charge (e.g., week, month, etc., for recurring charges)
  • A description of the goods or services being purchased

Example: Recurring charge of $120.00 on the 1st of each month to Green Leaf Catering for weekly office lunches.

Fill In Your Billing Information

Enter the billing address linked to your card, with your phone number and email address, so the business can match the charge to your card and reach you about it:

  • Billing address
  • Phone number
  • City, state, and zip code
  • Email address

Enter Your Payment Information

Choose either the Bank (ACH) or Credit Card option, and fill in the required fields for the customer’s or third party’s credit card information:

For Bank (ACH):

  • Checking or Savings account
  • Name on account
  • Bank name
  • Account number
  • Routing number

For Credit Card:

  • Visa, MasterCard, Amex, or Discover
  • Cardholder name
  • Account number
  • Expiration date (month and year)
  • CVV (card security code)

Review the Terms and Sign the Form

Read the terms before you sign, because your signature approves the charges the form describes and the schedule they follow. If you understand and agree with the terms, sign the form, and print your name. Also, provide the date of your signature.

Return the completed form to the merchant in the way it asks. Retain a copy for your records, and remember to notify the merchant in writing if you need to make changes or cancel the authorization. For a recurring debit from your bank account, you can also tell your bank to stop it, orally or in writing, at least three business days before the scheduled date of the transfer (12 CFR 1005.10(c)(1)).

Before you sign, check that the name, card number, and amount on the form match your card and your records.

Card Authorization Form vs. Authorization Letter

A card authorization form is a set of fields a business hands to its customer, while a credit card authorisation letter is a short note the cardholder writes to let another person use the card or to approve a charge for someone else.

PointAuthorization formAuthorization letter
Who prepares itThe business that will charge the cardThe cardholder
FormatSet fields and checkboxesFree text with the cardholder’s signature
Common useSingle or recurring charges by a merchantLetting a relative, employee or guest use the card or pay with it
What it namesCard, amount, schedule, business, cardholderCard, the person allowed, the purchase or stay, its dates
Who keeps itThe business, with a copy for the cardholderThe person allowed, to show the merchant

Use the form when a business will charge your card. Write a letter when you let another person use your card, and ask the merchant first whether it has its own form for that.

Frequently Asked Questions

Does a credit and debit card authorization form work for a debit card?

Yes, the same card authorization form works for a debit card: mark the card type, enter the debit card number, expiration date and security code, and sign it as you would for a credit card.

Can a business keep my card details for later charges?

Yes, once you sign a card authorization form, the business keeps your card details to charge you later, but only for the charges, amounts and schedule the form describes. Ask how it stores them, and cancel in writing when you no longer want the charges.

Can one form cover several payments?

Yes, a recurring card authorization form covers repeated payments: choose the recurring option, then list the amount, how often the charge happens, and the date or day of each billing period. For a single charge, choose the one-time option instead.

Do I fill in both the bank and the credit card sections?

No, pick the Bank (ACH) option or the Credit Card option, then fill in only the fields for the payment method you chose and leave the other section blank.

How do I cancel a credit card authorization?

To cancel, notify the merchant in writing that you withdraw the authorization, keep a copy of your notice, and ask the business to confirm that it will make no further charges to your card. For a recurring debit from your bank account, you can also tell your bank to stop the payment, orally or in writing, at least three business days before the scheduled date of the transfer (12 CFR 1005.10(c)(1)). For a card charge, you can also contact the card issuer.

Who keeps the signed form?

Both sides keep a copy of the signed card authorization form: the business stores the original with its payment paperwork, and the cardholder holds on to a copy in case a question comes up later.

Where can I get a free credit card authorization form template?

Use the free template on this page: click Create My Document, answer a few simple questions, save your progress, finish on any device, then download and print the finished form.

General information, not legal or tax advice.

Jennifer M. Settles
Jennifer M. Settles
Author & Attorney
With over 25 years of experience as a business and transactional attorney, Jennifer has mastered the craft of closing highly successful deals for her clients. Through her wide-ranging expertise in commercial contracts, real estate transactions, M&A and corporate law, Jennifer secures results that are second-to-none.