Lvl 3, 50 York St, Sydney NSW 2000, Australia

Credit Card Payment Authority

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Business Applicant (tick one)

Business Applicant (tick one)*

Company

Partnership

Sole Trader

Your Name*

Business Name*

Business Address

ABN / ACN / ABR*

Phone*

FAX

Email*

Postal Address*

Postcode*

Website

I/we as signatory for the Seo-Xpress.com Digital Services Agreement authorise Seo-Xpress.com a division of Club Web Pty Ltd to debit the following credit card for any fees that are due and payable from entering into an agreement with Seo-Xpress.com to provide web services as per stated in the Digital Services Agreement.*

Amex

Visa

Mastercard

Cardholder Name*

Cardnumber*

3 / 4 digit CCV*

Signature*

Expiry*

Thank you for choosing Seo-Xpress.com for your purchase today. Seo-Xpress.com is one of the leading suppliers of web design and search engine marketing services on the internet. Once you have completed the Digital Services Application Form and the Credit Card Payment Authority, your order will be processed and you will be given instructions on your internet service purchase. To insure delivery of your order information and GST Receipt, please be sure your email address is correct.

Terms Of Sale

A charge will appear on your bank statement under the name "CLUB WEB PTY LTD". Payments are processed by Stripe.
All prices quoted are in Australian dollars and are subject to GST (10%).
It is illegal to provide misleading credit card details. All attempts at fraud will be prosecuted.
Club Web Pty Ltd will never sell, rent or share your personal information with any company not directly involved in processing your order.

I/we (The Applicant) hereby acknowledges completing this Credit Card Authority Form for the services described in accordance with the Proposal and Terms and Conditions of service. By submitting this Form I/we agree to the Terms and Conditions for services at https://seo-xpress.com/agreement/.

Signed on Behalf of Applicant

Name*

Date*

Signature*