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RALEIGH ENDOCRINE ASSOCIATES ENDOCRINOLOGYDIABETES & METABOLISMFinancial Policy Update Effective May 1, 2019 PATIENT RESPONSIBILITIES: You will be asked to show your current medical insurance card
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How to fill out credit card on-file authorization

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How to fill out credit card on-file authorization

01
To fill out a credit card on-file authorization, follow these steps:
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Start by obtaining the credit card authorization form from the merchant or service provider.
03
Fill in your personal details such as name, address, contact information, and account number.
04
Provide the exact amount or maximum limit that can be charged to your credit card.
05
Include the expiration date of your credit card to ensure validity.
06
Sign and date the authorization form to acknowledge your consent to allow charges on your card.
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Review the filled form to ensure accuracy and completeness before submitting it to the merchant or service provider.
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Keep a copy of the filled credit card authorization form for your records.

Who needs credit card on-file authorization?

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Credit card on-file authorization is commonly required by businesses and service providers that offer recurring payments or maintain customer accounts.
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Examples of who needs credit card on-file authorization include:
03
- Subscription-based services like streaming platforms, software providers, or membership websites that bill customers periodically.
04
- Utilities companies that automatically charge customers for monthly services.
05
- Hotels or car rental agencies that may need to charge additional fees or cover damages.
06
- Online shopping platforms that offer 'save your card' or 'one-click purchase' functionality for seamless transactions.
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In general, any merchant or service provider that wants to streamline payment processes and reduce the need for manual authorization for each transaction may require credit card on-file authorization.
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Credit card on-file authorization is a process that allows businesses to store a customer's credit card information securely so that future transactions can be processed without requiring the customer to re-enter their details each time.
Businesses that store and charge customers' credit card information for recurring payments or future transactions are required to implement credit card on-file authorization.
To fill out a credit card on-file authorization, a customer typically needs to provide their credit card number, expiration date, billing address, and any security codes required by the merchant as part of a form or agreement.
The purpose of credit card on-file authorization is to facilitate easier and quicker transactions for customers, while ensuring that merchants have permission to charge the stored card for services or products.
The information that must be reported typically includes the credit card number, cardholder's name, expiration date, billing address, and any applicable terms regarding the storage and usage of this information.
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