The following authorization form may be used as a guide for creating an electronic or paper credit card authorization form for your organization.
Using a credit card authorization form does not guarantee that a customer or bank will not issue a chargeback, nor does it guarantee the outcome of a chargeback.
Velocity Processing is a registered Independent Sales Organization (ISO) / Member Service Provider (MSP) of Elavon, Inc. Georgia, a wholly owned subsidiary of U.S. Bancorp, Minneapolis, MN. Elavon has been processing electronic payments for 37 years and maintains an "A+" rating with the Better Business Bureau.
"Visa", "MasterCard", "American Express", "Discover", "OptBlue", "Apple Pay", "VeriFone", "ARB", "CIM", "PulsePoint", "Global Learning Lab", and "CardX" are trademarks and/or service marks of their respective owners.
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