Thank you for selecting Best1Hosting for your internet presence!
Below is our authorization form that you will need to print out and fax back to us. This form gives Best1Hosting authorization to bill your credit card for your hosting charges. This form MUST be completed in order for your new account to Be allowed to remain on our servers. If you have any questions please let us know: firstname.lastname@example.org .
233 Memorial Dr
Bath, Pa 18014 USA
Fax: (610) 837-7752
Domain Name: _________________________________
Today's Date: _________________________________
Hosting Plan: ______________________________
Plan Cost: _________________________________
Total Billing Charge: _________________________________(monthly/Yearly/quarterly)circle one.
Cardholder Name: _________________________________
Cardholder Billing Address: ______________________________
City State Zip Code: _________________________________
Credit Card Number: _________________________________
Expiration Date: __________
Credit Card Type (circle one):
Cardholder Telephone Number: ________________________________
E-mail address for billing issues: ________________________________
To authorize billing to the above credit card, please sign below:
My signature states that I authorize Best1Hosting to charge webhosting fees to my credit card as specified above. These charges will cover a Monthly,Quarterly or 12-13 month period from the date above. This authorization is valid until revoked in writing.
**All cancellations must be received in writing by the 1st of each month. Acceptable forms of cancellations are regular mail, fax, or e-mail. Phone requests will not constitute acceptance of any cancellation.**