Credit Card Authorization Form

I understand and acknowledge the charge I hereby authorize for the above-specified services. This payment authorization is for the type of bill indicated above. 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, provided the transactions correspond to the terms indicated in this authorization form. I further agree that, by signing this agreement, I am agreeing to the terms and conditions, and privacy notice, of the website through which I contacted SIA, Inc., and those of all related websites owned and operated thereby.

Your credit card charge will appear as “SIA, Inc.” on your statement.