Authorization for Charge Card

Primary Client Name

Please enter whatever name is shown as the primary client.

Date that Your Services are Expected to Begin

Date of your expected arrival, meeting, and/or initiated consulting (if applicable)

Contact Methods before Services/Travel

At least one phone number and E-mail address for each traveler. Please identify your informational preferences for any assistants, and/or other contact individuals.

Urgent Contact Methods during Services/Travel, if Different

Please provide at least one mobile number and E-mail address that can be used urgently. Please provide informational protocols for any assistants, security heads, and/or other representatives.

Cardholder or Accounting Contact, if Different

Please provide all relevant contact information and informational protocols that we should follow.

Card Type

MasterCard

American Express

Visa

Discover

Gift Card--Merchant Name and Any Supplemental Codes:

Please coordinate with your concierge if you are using JCB, a gift card, or would like to pay by other means.

Name(s) Shown on the Card

Please provide the complete name(s) as shown on the card. This is may be validated by US merchant processors upon their request.

Card Number

If the card number was separately provided, only the last four digits are needed.

CVV

Three- or four-digit code

Expiration Month

Year

Please enter two digits

Full Billing Address of Card

Complete billing address, as shown on the card statements

Comments

All services that we provide are individualized. Please inform us of how we can best serve you.

Please do not hesitate to contact Dignitary Discretion with any questions or concerns. We cordially welcome the opportunity to serve you in any way, and we want you have full understanding of the arrangements.

I hereby authorize charges up to my liability to Dignitary Discretion, as shown on the latest accounting statement sent to me, plus, if applicable, subsequent charges for future liabilities of mine to Dignitary Discretion, in accordance with https://www.dignitarydiscretion.com/finance/expenditures-without-surcharges.html and links thereon unless I sufficiently fund my account in advance via other methods.

I understand and agree to the sophisticated protocols for protecting my confidentiality as described at policies.DignitaryDiscretion.com/transactions and therefore shall anticipate multiple third-party transactions, cumulatively not to exceed my liabilities to Dignitary Discretion. Any refunds that are subsequently payable by Dignitary Discretion shall be issued as explained at policies.DignitaryDiscretion.com/refunds without directly reversing third-party charges.

Your concierge supports you with private service.

Authorization for Charge CardDebit • Credit • Prepaid