© 2018 Action Maid Service. All rights reserved.
Credit Card Authorization
Name as it appears on card
Type of credit card
CVV code back of card Zip Code
AUTHORIZED USER INFORMATION
Driver's license number
Type of charge
Date of charge Select Charge Type
I certify that I am the authorized holder and signer of the credit card referenced above. I certify that all information
above is complete and accurate.
I hereby authorize collection of payment to Action Maid Service for charges as indicated above. Charges may
not exceed the amount shown in the AUTHORIZED AMOUNT field.
I understand that any and all complaints about the service preformed must be made within 3 DAYS from above date.
All complaints must be put in written form via EMAIL to Michele@actionmaidservice.com or TEXT to 410-608-0591
Electronic signature authorizing Action Maid Service to charge credit card
After you submit your information you will be redirected to our cancellation page. Please read our cancellation policy.