PREAUTHORIZED CREDIT CARD PAYMENT | Chatham-Kent Association of REALTORS®

From*
First Name Last Name
Email*
Invoice #*
Amount*
(Including HST)
Card Type*
- Visa
- Mastercard
Card Number*
Name of Cardholder*
First Last
Expiry Date*
CSV*
Initial*
I/We herby authorize and consent to charge the above account for the fee as stated above.

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