Credit Card Authorization for Online Payment

By Phillip Graham,2014-07-01 11:09
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Credit Card Authorization for Online Payment

Serial No.:

    Credit Card Authorization Form for Online, Over the Phone & / or

    Mobile Payment

    If you would like to use Vodafone Egypt’s Online, Over the phone & / or Mobile Payment Service to pay the Vodafone bill. Kindly complete this form and include a photocopy of front and back of signed credit card and fax it to 02- 529-2676. Once your form is processed and accepted you will be able to make Online, Over the phone & / or Mobile payment. The mobile no. listed below will be used to notify you for initiation of service and transaction (s) confirmation. ? For Online Payments register and log on to our website at ? For payments Over The Phone, please call 881 from your mobile. ? For Bill payment & / or Recharge, please use your Vodafone SIM menu on your mobile. Should you have any questions, please call 881 from your mobile.

     Customer Information

    Name must be as it appears on your credit card.

    Name Birth Date Vodafone Account Number (as Mobile No.

    DD/MM/YY it appears on the mobile bill)

     010- Address must match your credit card billing address.

    Street Name and Number Apartment Number

    District Postal Code City

    Work Phone Home Phone Alternative Phone ( ) - ( ) - ( ) -

Payment Information Payment Method (Please check beside desired method)

    ? Online Payment or Over ? Direct Debit (Post-Paid The Phone by ? Mobile Payment Only) calling 881

    Card Type

    VISA Master Card Bank Misr Card

    Credit Card Number Exp. Date MM / YY

     CVV (4 or 3 digit printed on the signed strip next to your card number) ‘Optional’

    Date Credit Card Holder’s Signature: X____________________________________ / /

     In case of authorizing bill payments to accounts other than that of credit card holder I herby authorize to make bill payments from my credit card mentioned above to the benefit of the customer’s mobile account number mentioned herein below.

    Name Vodafone Account Number (as it Mobile No.

    appears on the mobile bill)



By signing this form, I hereby confirm that the information filled above is true and correct. I accept the terms

    and conditions on the reverse side of this agreement. I understand and accept that if the information filled Page 1 of 2 are incorrect, Vodafone Egypt reserves the right to disconnect the service until I provide the correct

    information. Where applicable I authorize Vodafone Egypt to charge my credit card in accordance with the

    payment terms agreed upon. Customer’s Signature: X______________________ Date: / /

    Serial No.:

    Credit Card Authorization Form Terms and Conditions:

    ? By my signature to this application, I hereby authorize Vodafone Egypt to

    charge my Credit Card when used in conjunction with the Vodafone Egypt

    payments services, which I provide its details herein and which I provided

    a photocopy attached to this application.

    ? I understand that based on my signature and the correctness of my

    information Vodafone shall be authorized to charge my Credit Card of the

    amount I request to Vodafone, therefore, I hereby represent and warrant

    that I shall not object without guaranteed right to any payment(s) charged

    to my credit card by Vodafone Egypt in accordance with the terms and

    conditions herein to my card issuer.

    ? This application, upon its completion and signature, shall be considered

    an integral part of the mobile service agreement I signed with Vodafone. ? I understand that I may request for payment(s) for other mobile numbers

    and that I may not use this to claim or object to such payment(s) to the

    card issuers.

    ? I understand that continuation of the service is a decision of Vodafone

    Egypt with no further liability to myself.

    ? The Payment Notification in any of the following methods (SMS Email

    Phone confirmation) will be considered a proof of payment unless

    Vodafone or the Credit Card issuer can prove otherwise. The customer

    may request a payment(s) certificate from Vodafone at any time upon

    affecting the payment(s). This request shall be made to the address: 7 A

    Corniche El Nil, Maadi, Cairo, 11431 Attn. Legal Manager. This request

    may require more than 24 hours for processing.

    ? The regular service level for reflection of payment(s) on our system is

    48hours from time of transaction.

    ? Unscheduled and scheduled downtime for the service is expected which

    could result in an inability to access the service & execute payment(s) or a

    delay in payment(s) reflection.

    ? For online payment(s) Credit Card information is provided through a

    secured web site, which is provided by a third party provider. Your claims

    regarding any leakage of information shall directed to this third party

    provider upon prior arrangement with Vodafone.

    ? Any claim that may arise out of or in connection with these terms and

    conditions or the application of this service shall be resolved in

    accordance with the Egyptian laws in effect and shall be subject to the

    jurisdiction of the Cairo court exclusively.

    ? I understand that I may require further services from Vodafone and that I

    hereby authorize Vodafone to charge my credit card for the fees for any

    additional service I may require.

     Page 2 of 2 Customer’s Signature: X_________________ Date: / /

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