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PayMate Authorization Form |
PayMate Authorization Form
| See It Through (SIT) accepts PayMate as a payment option. To pay by PayMate for SIT services, we MUST first have the following signed statement on file, detailing your PayMate account information. This information is used to identify your funds when they are paid to SIT, so that they are applied correctly. We reserve the right to deny any payment received via PayMate from an account not on file. After submitting this form to SIT via fax or postal mail (using the fax # or address listed below) you may pay your monthly bill by sending money via PayMate to verified PayMate user paymate@seeitout.com. |
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| Customer name (Last, First): | ______________________________ |
| Company name: | ______________________________ |
| PayMate Account name: | ______________________________ |
| Verified PayMate address: | ______________________________ |
| Address line 2: | ______________________________ |
| Address line 3: | ______________________________ |
| Work Phone: | ______________________________ |
| Alt. Phone: | ______________________________ |
| Fax: | ______________________________ |
| E-mail: | ______________________________ |
| Account Name: | ______________________________ |
| I authorize See IT Through (SIT) to accept funds from my PayMate account listed above for those charges for
SIT service that I may accrue from month to month. I understand that this authorization does not set up
a recurring billing process, and that I will still be obligated to initiate payment when it is due. This authorization is valid until revoked in writing. |
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| _________________________ | ___________________________ |
_____________ |
| Name (signed) | Name (printed) |
Date |
See It Through |
E-mail: sales@seeitout.com |
PO Box KL602 Kings Langley NSW 2147 Australia _________________________ |
Ouside Australia |
Ph: (61) 2-9624-7220 |
Fax: (61) 2-9624-7220 |
From Australia |
Ph: 02-9624-7220 |
Fax: 02-9624-7226 |