Credit Card Payment Authorization Form

I,

*  
of  CJS Distributing LLC  located at  13644 Hwy 57, Evansville, IN 47725, USA authorize Cahoot Technologies LLC to auto-debit my card below as listed below. I understand that all Cahoot sales are final. I also understand that all Cahoot charges and fees are non-refundable.

Recurring Amounts Authorized (Auto-Debit):

Starting June 22, 2024 (Monthly) : $1,299 $349 per month (Three Hundred Forty-Nine Dollars Per Month) Platform Fee

Starting June 3, 2024 (Weekly): All Cahoot fees (including postage and carrier shipping fees) from the previous calendar week will be auto debited on a weekly billing cycle. Invoice will be provided to the Client in advance. Per the signed agreement, a refundable security deposit fee will be required if the weekly out-of-pocket postage/carrier fees exceed $300.00 (three hundred dollars).

Credit Card Details*

Credit Card Type:*  
Credit Card Number:*  
CVV (Security Code):*  
Expiration Date:*  
Cardholder Full Name:*  

Billing Address*

Address Line 1:*  
Address Line 2:
City:*  
State:*  
Zip Code:*  
Country:*  

Print Details*

Print Name:*  
Print Title:*  
Date:*  

Documents*

Please complete this form and upload a photocopy of the front and back of the credit card above along with the cardholder’s driver’s license or passport main page.
Upload Documents:*  
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