What is Recurring Credit Card Authorization Form? How to Fill It?

To give authority to a merchant or company to charge their credit card regularly on the specific dates, the recurring credit card payment authorization form is filled. The cardholder can pay their bills on the timely basis and automatically with these recurring payments and avoid the stress of paying online all the time. This way, a cardholder can easily avoid any potential service charges and late fees.

Specify the card details in the form, such as account holder name, number, CVV, expiry date, and zip code. When the payment is usually paid on monthly basis, the cardholder can easily customize the number of times they can pay for the services, by filling the form.

How to Write the Form?

  • First of all, download the recurring credit card payment authorization form template in either .docx or PDF format.
  • Read the paragraph which opens and understand the terms given in the form and make sure you agree to them. Fill the following information –
    • Your name
    • Name of merchant
    • Amount to be charged to credit card
    • Day when the amount is charged
    • Frequency (week, month, year etc.)
  • Submit the billing information, including your phone number, email address, and billing address.
  • Now provide the card details, including the type of card (MasterCard, Visa, American Express etc.), the name of cardholder, CC/Account number, Expiry Date, Zip Code, and CVV.
  • Read over the paragraph like “I understand that this authorization…” before you enter the merchant’s name once again. Fill the date, print out the form, and enter your signature.

Tips to Fill Visa Compliant Credit Card Authorization Form

Do your customers provide fax order forms to your business? Are you a B2B company who is looking forward to storing credit card data for recurring billing on file of variable amounts? A usual fax authorization form doesn’t comply with Visa requirements. It is important for a recurring billing order form to comply with the standard receipt needs and recurring rules.

Tips to Prevent Chargeback for B2B –

  • For doing this, you need to send receipt through email to the cardholder just after charging the card. If there is any dispute, the issue will be resolved quickly.
  • Send billing detail.
  • If you send e-invoice to the cardholder and they just click and pay, use EBPP. It is very difficult to dispute in ordering the items.
  • Bill and ship to the addresses that match. Be sure to have something in writing from the cardholder and make sure they authorize shipping to any other address.
  • Get a signed recurring credit card billing authorization form when it comes to storing the data.
  • Be sure the receipts have ‘repeat sale’ or ‘recurring’ sale for recurring billing.


To address all the options to ensure compliance with fax authorization, there are so many variables. To comply with PCI DSS standards, it is recommended to replace all the typical forms with credit card exposed or check information with one which defines tokens, an alpha-numeric string which is the perfect alternative to credit card data out of your payment processing.