Credit Card Authorization Form

Reservation Confirmation #

Cardholder Information

Credit Card Information

Billing Address

Address

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I hereby authorize "BLACKCARMIA LLC" to charge my credit card for transportation services according to agreement that was received - confirmation email.
I acknowledge that all services booked by phone, email, text message, online, or signed agreement are considered authorized transactions. Any complaint or concern regarding the service provided must be reported to the Company at the time of service or immediately upon completion of the trip so the Company has a reasonable opportunity to address and resolve the issue.
Failure to report concerns during or immediately after the service may result in denial of refunds, credits, or disputes related to the reservation.
I understand and agree that this signed authorization form, together with invoices, confirmations, emails, text messages may be used as proof of authorization and services provided in the event of a payment dispute or chargeback.

Payment Confirmation
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