Credit card authorization form

Instructions: If you're not paying online and we don't have this info on file, please fill out this form to authorize us to bill your card. Please DO NOT ENTER FULL CARD NUMBER - call 415-386-7697 to give us the rest of the information. Charges will appear on your statement as: LT. Thanks!

I authorize a charge to my credit card by Lovings, Inc (Lovings.com) on this day, 12/12/2024, for the amount agreed to and entered by myself below, on terms I chose to select below. I confirm that I'm in full legal possession and have the right to use this credit card, and have contracted Lovings, Inc for the services to be rendered upon payment.

Upon the receipt of the services, I agree to contact Lovings, Inc first, before taking other steps, for any disputes, refunds or credits. I understand and agree that by signing this document I give Lovings, Inc the right to use this and other necessary information ONLY to perform services rendered and as legally needed, including credit card fraud or chargeback fraud disputes. Lovings, Inc agrees to keep the information herein protected and handle it in a safe manner as required by law.

Amount: $

Please enter amount WITHOUT a dollar sign.

Charge me (check one): *

One time

Monthly for 10% discount until I cancel

I'm paying by *

Last 4 digits of the credit card *

Cardholder name *

Enter the full name on credit card

Credit card expiration date

Please enter in format MM/YY

Billing address

Zip code *

Electronic Signature - Full legal name *

Phone *

We will contact you by phone for the full credit card number, for the safety of your credit card account.

Upload picture ID of the card holder

Maximum file size: 268.44MB

Having trouble? You can email ID to sales@lovings.com instead. If we don't already have the ID of the cardholder, please upload it here as the proof of ownership and right of use of this credit card.