Maranatha Construction

Credit Card Authorization Form

Your name:          

Your billing address:    

Your credit card number (MC/VISA/Disc/AX):

Your credit card expiration date:

Your credit card code (last 3 digits on the signature panel; or if AMEX, the 4 digits on the face of the card): 

Indicate if you want to pay with Paypal (credit card fee still applies):________

Credit Card Acceptance Agreement

Moisés Blas, contractor, (“Contractor”), DBA Maranatha Construction agrees to accept payment by credit card for your construction project only as a convenience to you in exchange for this convenience, the following terms apply:

1.         You may not dispute this credit charge with your credit card provider, and

2.         There are no credit card refunds issued by the Contractor unless the Contractor dies and is unable to complete the contract or is injured and cannot complete the contract within 60 days of such injury, and

3.         You have purchased a service that is not refundable, and

4.         You may not flat cancel the contract after the credit card transaction is complete, and

5.         This agreement does not survive in the event that the Contractor is convicted of a construction crime against you (which has never happened and will never happen).

6.         If you use Paypal, and you make an error entering the correct amount due; any Paypal fees resulting from a refund of the erroneous amount are deducted from your refund. In other words, we are not responsible for paying Paypal fees to charge and refund erroneous amounts entered by you.

I agree to the foregoing terms:


_____________________                    ____________

homeowner signature                                Date


TBA                                                              __________

Contract Number                                       Effective Date


$                                                + 2.5% MC/VISA/VISA debit, or 3.5% DISC, or 4.5% corporate card/world card/rewards card

Amount charged to credit card  (Circle the type of card used above. If you don’t circle a card type above, we will automatically charge 4.5%. If your credit card charges us more than the percentage indicated above, we will charge the difference to your credit card within 45 days. No fee will be more than 4.5%.)



Date of charge      


Please, fax or mail this form back to Maranatha Construction, 4 Peace Pipe Lane, Fredericksburg VA 22401 or by fax to 1-703-997-5999 to Accounting with a COPY OF YOUR DRIVER’S LICENSE within 48 hours.  For security purposes, you may block out your driver’s license number if you want.

Copyright © 2008-2010 Chase Web Design. All Rights Reserved.