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A one time card authorization form is signed consent for one charge. Our builder on this page creates the credit card authorization form online, ready to print and sign. Merchants and customers use it when the card is not swiped in person.
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A one time credit card authorization form is a document a customer signs to let a merchant charge their credit card for a single agreed payment, usually when the two do not meet face to face.
The form names the merchant, the cardholder, the amount and the payment day. It covers that one payment and sets up nothing after it.
A card issuer's authorization is the electronic approval or decline a merchant receives when it runs a card, while this form is the customer's written permission given to the merchant beforehand.
Both use the word authorization, but a signed form does not tell you how the issuer will respond. The card can still be declined when the merchant runs it.
Merchants and customers each get a written reference from a single-use authorization, which helps when a question about the payment comes up later.
To create a credit card authorization form online, select Create My Document on this page, answer the builder's questions, then download and print your finished form for signing.
The merchant you are paying may hand you its own version instead. The same parts apply, so the field guide below still helps you read and complete it.
A digital credit card authorization can carry an electronic signature: under 15 USC 7001(a), a signature in a transaction affecting interstate or foreign commerce may not be denied legal effect solely because it is in electronic form.
Under 15 USC 7001(b)(2), a business does not have to agree to use or accept electronic signatures. Ask the merchant whether it takes them before you send a digitally signed form.
A one time authorization works best when you plan to bill a card once and do not expect to bill it again. If you run a small business, you may ask customers to sign one when their cards cannot be swiped in person, for example after they place an order by phone. These are common situations:
A one time authorization covers a single payment, while a recurring authorization covers repeated payments on a schedule, such as a monthly membership or service plan. The table below shows how the two compare for a small business and its buyers.
| Feature | One time authorization | Recurring authorization |
|---|---|---|
| Number of payments | One | Several, on a schedule |
| Typical use | Deposits, one-off orders, single invoices | Memberships, subscriptions, ongoing services |
| Card information | Used once for the agreed payment | Kept on file for the later payments |
| Next purchase | Fill in a new form | The same form covers it |
To choose between them, count the charges you expect. A single charge calls for the one time form, and a repeating charge calls for the recurring form.
A one time credit card authorization form includes the merchant's name, the cardholder's details, the card details, the payment details and a signed authorization statement.
Some merchants add their own terms, such as a cancellation policy. Read those terms before you sign, because the signature sits below them.
A completed form might look like the sample below. All names and numbers are made up.
| Field | Sample entry |
|---|---|
| Merchant | Main Street Catering |
| Name on card | Anna Baker |
| Billing address | 123 Main Street, Springfield |
| Payment total | $150.00 |
| Payment day | June 15 |
| Description | Deposit for a company event |
| Card | Visa ending in 1234 |
| Authorization statement | I authorize Main Street Catering to charge $150.00 to this card one time, for the deposit described above. |
| Signature | Signed by hand |
To fill out a one time credit card authorization form, have your card and the merchant's details in front of you, then complete each field below in order and sign last.
Gather these items first:
Enter the merchant’s name or the name of the company you authorize to bill your credit card. This points the authorization to the right business and avoids any doubt about who receives the payment.
Write your full name exactly as it appears on the credit card, so the form shows who approves the payment. A different spelling can raise questions when the merchant checks the form against the card.
Specify the exact dollar amount you authorize to be charged to your credit card, including any tax, shipping or other cost you agreed to pay. Double-check this figure before you move on so it matches what you agreed to.
Indicate the day on or after which the payment can be processed, so both sides share a clear timeline for the charge.
Detail the goods or services you are paying for in a short description you could recognize later on a card statement. For a deposit, say what the deposit is for.
Fill in your billing address, phone number, city, state, zip code, and email address. Use the address your card issuer holds for the account, since the merchant can use it to verify the payment and send a receipt.
Write your card type and fill in your cardholder name, account/credit card number, expiration date, CVV code, and billing zip code. Read the card number back digit by digit before you move on, because a wrong digit can stop the charge.
Conclude by signing your name and dating the form, the step that shows you approve the payment described above. Make sure the day you sign is the same as or earlier than the day the payment is processed.
Keep your card number private. Give the signed form only to the merchant you are paying, and avoid sending it by regular email or text message.
A credit card authorization form is only as safe as the way you send and store it, because the signed form holds the full card number, expiration date and CVV code.
If a merchant offers only regular email, ask for another way to pay, such as a payment link or a call with its billing staff.
Once the form is signed, a few habits keep the payment smooth for the merchant and the customer. These tips suit any business that takes card payments by phone, mail, or online.
A merchant holding a signed form holds a customer's card details, so check the form before charging and limit who can reach it afterward.
A customer should leave the original with the merchant and hold on to a signed copy, because that copy is the reference for checking the charge.
Store your copy in a safe place, and compare it with your card statement when the payment posts. Check that the amount, the merchant's name and the date all match what you signed.
Regulation Z, at 12 CFR 1026.12 and 12 CFR 1026.13, covers unauthorized credit card use and billing errors, while your signed form shows what you approved.
This summary covers those federal sections only. Neither section sets wording for a one time form.
Under 12 CFR 1026.12(b)(1)(i), unauthorized use means use of a credit card by a person other than the cardholder who has no actual, implied or apparent authority, and from which the cardholder receives no benefit.
Under 12 CFR 1026.12(b)(1)(ii), a cardholder's liability for unauthorized use is limited to the lesser of $50 or the amount obtained before the card issuer is notified.
Under 12 CFR 1026.12(b)(2), that liability applies only if the card is an accepted credit card, the issuer gave adequate notice of the maximum liability and of how to report loss or theft, and the issuer provided a means to identify the cardholder or authorized user.
Under 12 CFR 1026.12(b)(5), a card issuer and an organization with 10 or more employee cards from that issuer can agree to liability terms outside this section, though any liability placed on an employee stays within it.
Under 12 CFR 1026.12(b)(3), you can notify the card issuer of a possible unauthorized charge in person, by telephone or in writing.
If a charge does not match the form, compare it with your signed copy and ask the merchant to correct it, then go to your card issuer if it stays wrong.
Under 12 CFR 1026.13(a)(3), billing errors include a charge for property or services that you or your designee did not accept, or that were not delivered as agreed.
Under 12 CFR 1026.13(b), a billing error notice is a written notice that your creditor receives at the address it discloses for that purpose, no later than 60 days after it transmitted the first periodic statement showing the alleged error.
Under 12 CFR 1026.13(b)(2) and (b)(3), the notice lets the creditor identify your name and account number and, to the extent possible, gives your reasons for believing an error exists and the type, date and amount of the error.
Keep that date in view while you talk to the merchant.
Under comment 3(a)-2.i of Supplement I to 12 CFR Part 1026, these billing error rules do not apply to a business-purpose credit card, even for an occasional consumer purchase made with it.
Under comment 3(a)-2.ii of Supplement I to 12 CFR Part 1026, they do apply to a consumer-purpose credit card, even for an occasional business purchase made with it.
If you hold a business-purpose card, check your card agreement for how to dispute a charge.
A one time form does not give another person use of your card, because it only lets a named merchant charge one agreed payment. To let someone else use your card, contact your card issuer about adding an authorized user, and ask what that means for your account and its charges.
You can use this form to pay for another person's purchase with your own card, because you sign as the cardholder and the description can name that person. If the card belongs to someone else, the cardholder fills in and signs the form instead of you.
A signed one time form covers the single payment it describes, so it has no ongoing term once that charge goes through. A temporary hold on a card is a different thing, and your card issuer or the merchant can tell you how long a hold lasts.
If the payment has not run by the day you expected, ask the merchant before you sign a new form, so the same payment is not charged twice.
A one time form covers one payment, so a second purchase takes a fresh form with the new amount and day. If you expect regular billing, ask the merchant about a recurring form instead.
A one time authorization gives permission for one agreed payment, not for holding your card for later charges. Permission for later payments belongs on a recurring form, and you can ask the merchant how it stores or destroys your form after the payment.
A signed form gives a merchant written evidence of what the customer approved, but it does not guarantee how a dispute will end. A clear description, an exact amount and a legible signature make that evidence easier to read.
General information, not legal or tax advice.
