Credit Card Form for Members’ use

FORM FOR ACCEPTING PAYMENT BY CREDIT CARD“A Clayton’s Secretary” can now assist you with acceptance of Credit Card payments from your clients. Cards accepted are Visacard, Mastercard, and American Express (AMEX). Instant approval/non-approval given – it is now handled electronically from our office. We will require from you the following information.Please note: It is most important you advise the client that the credit card charge will show “A Clayton’s Secretary” on their statement – if they don’t know this they might try to get it charged back which incurs extra costs and inconvenience.

Name of customer as shown on their credit card.
Credit card number and expiry date plus CVV or CVN number. The bank now requires this information to be included for processing.
Amount of sale and sale item – this needs to be entered onto form.
Your name and address – for mailing cheque back to you.

Customer Name:
Credit Card No:
Expiry Date:
Sale Item:	M/C V/C AMEX (Please cicle) CVV No (on back of card)
Amount of Sale:		Date of Transaction:
Your Name:
Your Address:
Your Telephone:
The cheque will be made out in the name you enter above and posted to the address you list.
Or, if you wish the amount to be paid by EFT, please add your bank a/c number and name of account: ……………………………………………………BSB:………………………A/C………………………………………

There is a charge of $3.00 for administration charges, plus 2.4% merchant fee charge. (If Amex the fee will be higher) A cheque will be sent back to you, or direct bank transfer can be carried out, after credit card payment is banked, usually within 48 hours of processing. I make nothing from this – the fees simply cover the fees I incur.

Please print this form and keep for copying.

ccform

Credit Card Form for Members’ use

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Credit Card Form for Members’ use

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