EMPLOYEE
CREDIT CARD
AUTHORIZATION FORM
   
                                           
                                           

 
EMPLOYEE AND COMPANY INFORMATION  
                                           
                                           
  JOHN DOE     COMPANY NAME  
  Name     Company  
                                           
  #50505050     200 COMPANY BAY, ORLANDO, 18555 NY  
  Personal Number (Company ID)     Address  
                                           
  TRAVEL AGENT     ANNA SMITH  
  Business Role     Person Responsible Name  
                                           
  SALES     CEO  
  Team     Person Responsible Business Role  
                                           
                                           

 
CREDIT CARD TO BE CHARGED FOR PAYMENT  
                                           
VIS
  ☐ MasterCard     ☐ A     ☐ American Express   ☐ Other (write here)  
                                           
  Account Number   25560000-00000-52544   Expiry Date 03/2027  
                                           
  Cardholder (Organization) Company Name   CVV Code 0055  
                                           
  Billing Address 255 Company Avenue, Orlando, 18555 OR  
                                           
                                           
    The Company that is owner of the credit card above with the credit card number above, understands and agrees to be    
    personally liable for all charges incurred by the employee named above that fall into one of the following categories:    
• Business-Related Travel,
• Meals,
• Hotels,
  • Car Rentals  
• Lorem Ipsum

This is authorized by COMPANY NAME responsible person named above.

   
                                           
   
           
  AUTHORIZED PERSON SIGNATURE         DATE  
                                           
                                           

 
ITEMS TO BE DELIVERED
       
       

                 
We will need any document that can clearly state that the person using the card is an
  employee of your company as well as a clear copy or photograph of the credit card    
indicated above (Front & Back). You can email this completed authorization form, copy

 
of ID and copy of credit card.
  SERVICE PROVIDER NAME  
                   
     
           
IMPORTANT NOTES 151 Servicing Avenue
     
The employee indicated above received the corporate credit card indicated above and
takes responsibility for all expenses charged to credit card indicated above. Philadelphia, 20100 PH
     
The employee is committed not to charge any personal expenses to the corporate (555) 100-0000-0000
  credit card. All receipts for charges to the corporate credit card must be submitted to    
the finance office.
info@serviceprovidername.com
     
                     
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