This credit card authorization form acts as authorization for both the security deposit on the rented equipment and as guarantee of payment. Professional Photo Resources Inc. requires that this form be completed and returned before the rental can be completed.

You may also download this form as a PDF and fax it to (404) 885-9706.

Personal Information

Your Name (required)
Your Email (required)

Credit Card Information

Name as it appears on card
Card Number
Expiration Date
/
Card Verification #

Billing Address

Name (required)
Address (required)
City (required)
State (required)
Zip (required)
Phone (required)
Purchase or rental this form is in reference to
I hereby agree to, and authorize the use of my credit card as a security deposit against loss or damage of equipment and payment for charges relating to rentals and/or purchases from PROFESSIONAL PHOTO RESOURCES, INC.
I understand that if any equipment rented is returned in a damaged condition or rental charges are not paid, PROFESSIONAL PHOTO RESOURCES will submit charges for repairs and/or rental fees to my credit card.
I understand that if any equipment rented is returned damaged beyond repair or not returned for any reason by Lessee, PPR, INC. will prepare and submit charges to my credit card to cover accrued rental to the date the equipment is replaced; plus replacement costs of the equipment up to the deposit amount of the equipment as stated on the rental agreement.
I understand and agree to these terms as set forth in this document. I agree that the name below is the same on the credit card with the below stated number. I authorize Professional Photo Resources, Inc. to charge my credit card accordingly.
Signature (required)