Credit Card Authorization Form Template

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Credit card Authorization Form

In order for Living N Luxuries LLC to accept and bill your credit card, please complete all fields below,sign, date and click on submit.

All information sent is strictly confidential and Living N Luxuries LLC adheres to the highest standards of account data protection.
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Company:
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Client name* This field is required.
First Name
Last Name
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Phone Number* This field is required.
Area Code
Phone Number
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E-mail* This field is required.
Email must match to current email on file
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Property Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Property Type* This field is required.
AirBNB/Short Term Rental
Single Family Home
Apartment
Townhouse
Commercial
Dorm Room
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Bedrooms* This field is required.
One (1) Bedroom
Two (2) Bedroom
Three (3) Bedroom
Four (4) Bedroom
Five (5) Bedroom
Six (6) Bedroom
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Bathrooms* This field is required.
One (1) Bathroom
Two (2) Bathroom
Three (3) Bathroom
Four (4) Bathroom
Other
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Service Type* This field is required.
AirBNB Turnover Cleaning
Deep Cleaning
Move In/Move Out Cleaning
Office Cleaning
Standard Cleaning
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Frequency Type* This field is required.
One Time
Per Turnover
Weekly
Biweekly
Monthly
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Property Size (SQFT)* This field is required.
Under 1,000 sqft
1,000 sqft-1499 sqft
1,500 sqft- 1,999 sqft
2,000 sqft-2,499 sqft
2,500 sqft + 2,999sqft
3,000 sqft + 3,499 sqft
3,500 sqft + 3,999 sqft
4,000 sqft + 4,499 sqft
4,500 sqft + 4,999 sqft
5,000 sqft + 5,499 sqft
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Add-On Services
Inside Microwave
Inside Fridge
Inside Stove
Laundry
Interior Window
Eco-Friendly Supplies
Same Day/Priority
Carpet Cleaning
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Calculation
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Appointment* This field is required.
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Card Information Form* This field is required.Pricing varies based on square footage, condition, add-on services, and frequency. Final pricing is confirmed after booking details are reviewed.
prevnext( X )
My Bag
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My Bag
Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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ORDER SUMMARY
Total costUSD
Move In & Move Out Starting price for end-of-tenancy cleaning, perfect for property managers, landlords, real estate professionals, and residents preparing homes or apartments for move-out.
$299.00Edit
Back
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Quantity
Subtotal: $0.00
AirBNB /Short Term Rental CleaningStarting price for Airbnb turnover cleaning. Final pricing may vary based on the number of bedrooms and bathrooms, property condition, same-day or urgent requests, and any selected add-on services.
$169.00Edit
Back
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1
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AirBNB/Short Term Rental Turnover
Deep CleaningStarting price for deep cleaning. Final pricing will be determined after a full inspection of the property, with each room evaluated for the time and detail required.
$250.00Edit
Back
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1
2
3
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Quantity
Same Day/PrioritySame-Day / Rush Service: For clients needing cleaning services on short notice, a rush fee applies. This ensures your property receives priority scheduling while maintaining our high standards of quality and attention to detail.
$75.00Edit
Back
Total cost $0.00
First Name
Last Name
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Billing Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Please Check the Appropriate Box(es):* This field is required.
One Time Use: I hereby authorize Living N Luxuries LLC to charge the indicated credit card the amount indicated above. This is a one-time charge authorization. I am not authorizing Living N Luxuries LLC to setup my account within a recurring billing system. I understand that if I want Living N Luxuries LLC to charge any balances to my credit card in the future, I will need to submit another authorization form at that time or choose the selection below.
Recurring Billing: I hereby authorize Living N Luxuries LLC to charge the indicated credit card on aperiodic basis for the amount due under my contract with Living N Luxuries LLC as indicated above.This Recurring Payment Authorization shall remain in force until cancelled by me in writing.
A deposit is required to secure your cleaning appointment with Living N Luxuries LLC. Deposits are applied toward your total service balance and confirm your selected date and arrival window. Bookings are not guaranteed until the deposit payment is successfully processed through Stripe.
Cancellations made 48 hours or more before the scheduled service will receive a full refund of the deposit.
Cancellations made within 48 hours of service are non-refundable as the time has been reserved exclusively for you.
Reschedules are permitted one time with at least 48-hour notice without an additional deposit.
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Signature* This field is required.
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