Credit Authorization Form

By completing this form, your data is securely stored, processed in accordance with privacy laws, and used solely for the purpose for which it was collected, ensuring your information is protected and kept confidential.

To complete your purchase, please fill out the below information. This is required for all purchases equal to or greater than $1,500 in total value. This information verifies the legitimacy of the transaction and provides a clear record of consent.

Date

Customer Information

First name

Last name

Address

Phone

Email

Payment Information

Credit Card Type

Name on Card

Credit Card Number

Expiration Date (MM/YY)

CVV/CVC Code

Description of Goods/Services

Amount

Terms and Conditions: Payment will be processed upon receipt of this authorization. The information provided in this form will be used solely for the purpose of processing the authorized payment and will be kept confidential.

Authorization:

By signing below, I authorize meghanajewelers.com to charge the credit card indicated in this authorization form according to the terms outlined above. This payment authorization is for the goods/services described below, for the amount indicated above, and is valid for one-time use only.

I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated in this form.

Signature

Today's Date