Hosting Authorization | Xpertz eSolutions

Payment Authorization

Website Hosting Payment Authorization

Company *

First Name *

Last Name *

Email *

Credit Card Details

Name On Card *

Credit Card Number *

Expiry *

Sample: 09/2024

Security Code *

CVC

Credit Card Billing Address

Choose Your Address

Location Address

Billing Address

Other Address

Address

City

State

Country

Country

Postal code

Billing Address

Billing City

Billing Province / State

Billing Country

Billing Postal Code / Zip

Other Address

Other City/Town

Other Province/State

Other Country

Other Postal/Zip

I hereby authorize Xpertz eSolutions to use my credit card for monthly hosting of $45.20 ($40 / month plus HST).

Charges will be applied on the 1st of each month.

To cancel this service or revoke authorization, please send a written request 30 days prior to [email protected] for confirmation.

Authorization Signature