Credit card form II - Vodafone

Credit card form II
Charge my credit card every month
Authorisation form
Yes! I’d like to enjoy the freedom of ‘pay by card’ automatic debit of my monthly Vodafone bill through credit card belonging to and standing
in the name of
, my (relationship)
residing at
I understand that the said payment option is for facilitating me to make my Vodafone bill payments and I agree and confirm that the
responsibility and liability for payment of my Vodafone bill is on me and in the event of default by the credit card holder, I will be liable and
responsible for making the outstanding payments to Vodafone.
Customer’s name
Vodafone relationship number
Vodafone number
Customer’s signature
Acceptance
I, , residing at having a credit card, details of which are
below, hereby accept, confirm and agree to make payment of Vodafone bills relating to the below mentioned Vodafone number through my
credit card. The entire amount of monthly bill relating to Vodafone mobile phone rentals, Vodafone bills and/or related expenses on account of
the Vodafone relationship number
in the name of
Vodafone number
my (relationship)
residing at
should be debited to my
VISA Master Diners AMEX
Credit card number
Expiry date
Issued by
Date of birth
Vodafone India Limited

I understand and undertake that
• Expenses related to the aforesaid Vodafone number are to be charged to my nominated credit card (monthly, earlier, for any interim payment
or if and when accrued).
• The record of charges in respect of the above services received or availed by the aforesaid customer and submitted by Vodafone to my
credit card will neither bear my signature nor the imprint of my card.
• These instructions are valid on an ongoing basis till I issue instructions to the contrary in writing to the bank with a copy to
Vodafone Essar Spacetel Limited.
• I agree to advice Vodafone Essar Spacetel Limited, if my nominated credit card is cancelled, substituted or not renewed.
• I, therefore undertake to unconditionally honour and pay without demure and contestation the said charges when I am billed for the same
by the aforementioned bank.
Card holder’s signature (as appearing on the credit card)
Card holder’s name (as appearing on the credit card)
(Enclose a photocopy of both sides of the credit card)
Customer
Credit card holder and acceptor
Note
• Ensure that the credit card is in the name of the customer.
• Provide a photocopy of both sides of the credit card along with direct debit authorisation.
• Automatic debit to the credit card will take place 15 days after the bill date or as and when the need arises. In case the transaction is not
accepted, payment should be made by cash or cheque to avoid restriction of facilities.
• Authorisation will remain in effect till intimated otherwise by the customer.
• Intimation in writing would be required if credit card subscription is not renewed. In such a case the outstanding payment can be cleared by the
normal payment modes.
• For renewal of credit card subscription, you will need to submit fresh copies of the front and back of the credit card to Vodafone Essar Spacetel
Limited.
• All international credit cards are accepted.