Credit Card Payments

Payments Dashboard

Credit Card Authorization Form

Please complete the form below to authorize your credit card payment securely

Company Name(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Email Address for Receipts / Invoices(Required)

Card Type(Required)

Cardholder Name (as shown on card)(Required)

Card Number(Required)

3/4 Digit CCV(Required)

Expiration Date (mm/yyyy)(Required)

Cardholder Zip Code (from credit card billing address)(Required)

Authorization(Required)

I authorize OneKeel.ai to charge my credit card above for agreed upon purchases. I understand that my information will be saved to file for future transactions on my account. I have reviewed my pricing schedule and agree to all one-time and recurring platform charges. I understand that my lead generation charges may vary in quantity and price. I understand that an invoice will be provided to me by email prior to my card being charged.

I understand that this authorization will remain in effect until I cancel it in writing. I agree to notify OneKeel.ai in writing of any changes in my account information. If the periodic payment dates fall on a weekend or holiday, I understand that the payment may be executed on the next business day. In the case the credit card declines, I understand that OneKeel.ai may at its discretion attempt to process the charge again within 30 days. A 3% processing fee will apply to all transactions.

Date(Required)

Signature

Signature(Required)

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