Credit Card Authorization

Credit Card
Company Name*
Email*
Phone Number*
Payment Frequency*
- One Time
- Recurring
Payment Type*
- ACH
- Credit Card
ACH
Name on Account*
Account Type ( Checking/Savings )*
Account Number*
Bank Routing Number*
Credit Card
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Billing Address*
Street Address Address Line 2 City State ZIP Code
Authorization*
Cardholder authorizes Highforge to charge this card for outstanding invoices or ongoing services that have been approved by the cardholder
- Yes, I agree
Cardholder Signature*
Date*
MM slash DD slash YYYY

Notice: We follow strict PCI compliance standards to protect your payment information. Your data is never shared with any outside party except Intuit/QuickBooks, and only for the purpose of securely processing your payment. You can cancel recurring payments with 30 days notice by emailing [email protected].

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Credit Card

ACH

Credit Card