CREDIT CARD AUTHORIZATION

Payment Authorization Form

Please complete and sign this form to authorize Demand Mojo to process transactions on your credit or debit card as specified below.

By signing this form, you authorize Demand Mojo to charge your account for the amount(s) listed below on or after the indicated date.

Payment Terms:

For Project-Based Services (e.g., Website Development):
1. 50% deposit – Initial payment.
2. 25% deposit – Second payment.
3. 25% deposit – Final payment.
For Advertising Services (Monthly Billing):
1. Monthly Fee – 15% of total monthly ad spend.
2. Payments will be automatically charged on the first day of each month.

By signing this agreement, you acknowledge that all invoices are due immediately upon receipt. If payment is not received within 14 days, Demand Mojo reserves the right to charge your card for the total outstanding balance without further notice.

Disputes and Chargebacks:

If you initiate a chargeback or request a refund for authorized charges, Demand Mojo will submit this signed authorization form, client agreement, and evidence of completed work (e.g., domain delivery or advertising reports) to dispute the chargeback. An administrative fee of $100 will be charged to cover costs associated with the dispute process.

First name

Last name

Amount

Description of Services

Phone

Billing Address (Please include billing zip code)

Credit Card Type

Visa

MasterCard

AMEX

Discover

Cardholder Name

Credit Card Number

Expiration Date - (mm/dd/yyyy)

CVV (Card Verification Value): 3 digits on the back (Visa/MasterCard) or 4 digits on the front (American Express).

Authorization and Agreement

By checking this box, you authorize Demand Mojo to charge your credit or debit card as specified in this form. You confirm that you have read, understood, and agree to the terms outlined, including payment schedules, dispute resolution, and chargeback policies.

Please enter your signature below.

CREDIT CARD AUTHORIZATION

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