Credit or Credit Card Payment Authorization

Enter Your Details

⌂You Authorize transaction charge: You authorize Mulberry RV Park to charge regularly scheduled charges to your credit card.

⌂ Month to Month YOU AUTHOIRZE RECURRING CHARGES: You will be charged the amount indicated in your reservation term billing period rent, late fees, incidental repairs, store supplies, etc.

A receipt for each payment will be emailed to you and the charge will appear

on your credit card statement. 

You agree that no prior notification will be provided unless the date or amount changes you may receive notice from us at least 7 days prior to the payment

being collected.

I authorize Mulberry RV Park to charge my Credit card on file as stated below.

Bill this Credit Card Number

Card Details ☐ Visa ☐ MasterCard ☐ Discover ☐ American Express

Cardholder Full Name on Card: _____________________________________________________

 Provide Credit Card Number _________________________________________

Expiration Date ______ /______ CVV ________ Zip Code ________________

Credit Card Billing Address __________________________________________________________

City, State, Zip _________________________________________________________________________

Email _________________________________ Phone Number: _____________________________

I understand that this authorization will remain in effect until I cancel it in

writing, and I agree to notify Mulberry RV Park in writing email: mulberryrvpark@gmail.com of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date.

If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day.

I acknowledge that the origination of Credit Card transactions to my account

must comply with the provisions of U.S. law.

I certify that I am an authorized user of this Credit Card and will not dispute

these scheduled transactions; so long as the transactions correspond to the

terms indicated in this authorization form.

Digitally Sign the form to the left: