RDS Delivery Service | Credit Card Authorization Form

Order Tracking ID # or Invoice #*

Your order will not be processed until this form is received and confirmed.

Company Name*

Contact Name*

Address*

Mailing Address Room/Floor #: City State ZIP Code

Phone*

Email*

How did you hear about RDS?

Consent*

I authorize RDS Delivery Service to charge the amount for my order tracking ID # above provided on email or received by customer service representative. Please be advised this is a quote and orders will be adjusted accordingly when completed. Two Men and a Van and Lift Gate/Straight Truck Service are billed at an hourly rate with a 2 hr minimum. Fuel Surcharges, Parking Fees and Tolls billable where applicable.

Cardholder's Name*

Address*

Billing Address City State ZIP Code

Card Type*

Card #*

Exp Date*

Security Code*

On Visa, Mastercard, and Discover cards, the verification code is the three-digit number located on the back of the card. On American Express cards, the security code is a four-digit number found on the front of the card.

Please Provide a copy of credit card front and back and State Picture ID*

Max. file size: 512 MB.

By authorizing this charge you agree to the Limits of Liability: RDS Delivery Service Co., Inc., does not take responsibility for cash, jewelry, securities and fine art. RDS limits its liability to a maximum of $100 per delivery unless otherwise negotiated in writing. (1) all claims, requests for adjustments, or notification of errors must be made within 10 days in writing or charges are considered accepted; (2) RDS assumes no responsibility for the condition of the item being shipped; (3) RDS will not be liable for loss or damage caused by delay, or improperly packed and/or labeled deliveries; (4) Customer releases RDS and its employees and or agents from liability and responsibility for the condition of the items throughout the receipt and delivery process; (5) Customer represents to RDS that the contents of the shipment is not hazardous or illegal in nature. All work is subject to the Terms and Conditions above. Invoice payment terms and conditions: Please make full payment within 10 days of the invoice date. If any invoice amount is not received by the company, 30 days by the mentioned due date, then without limiting company’s rights the following will be applicable. Those charges may accrue late interest @ 3% of the outstanding balance per week, or the maximum rate permitted by law, whichever is lower. Service may be suspended to you until such amount is paid in full. We accept payments by check and ACH. All credit card charges have a service fee of 3.5% per order tracking ID.

Authorized E-Signature*

Date*

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Credit Card Authorization Form

RDS Same Day Delivery Credit Card Authorization Form