credit card authorization

Thank you for choosing

Value Waste Services

Please complete and sign this form, which authorizes Value Waste Services, Inc. to make a debit to your credit card listed below. Please return this form to ValueWasteServices@gmail.com. For any questions, please call (803) 250-3100.

Please complete the following information:

This payment information is for:
Account Type:

I authorize Value Waste Services, Inc. to charge the credit card indicated in this authorization form according to the terms outlined above. This payment authorization is for the goods/services described above. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated.