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CREDIT CARD AUTHORIZATION

Private




CONTACT INFORMATION

CARD INFORMATION


.

BILLING INFORMATION


* = Required

** = special submission message instruction.

I authorize Nick's Towing Service to charge the credit card indicated in this web form for the noted amount on today’s date. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company, so long as the transaction corresponds to the terms indicated in this web form.

 

You may be required to send a photo of your Driver’s License and Credit Card via fax, text, or email.







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