PAYPAL AUTHORIZATION FORM

You can find another print out located here  (http://hostnit.com/paypalauth.html )

 
PAYPAL AUTHORIZATION FORM

 

I, _______________________________ hereby authorize PayPal Transaction ID# _________________________  in the amount of US$ _________.____ which I am  authorized to send from the PayPal account with the registered email address of  ____________ @ _______________ to Rishi Padooman of, ™Host NIT Inc® accepting payment via PayPal registered email address: rishi@stkinc.co. By  signing this form, I agree with all terms and conditions of the sale/order, as specified in the Host NIT Inc™  Service Agreement(TOS) , which I have made over the phone,  by fax, or via the Internet. I also authorize any additional PayPal transactions I  may make in the future to Host NIT Inc™, applied towards recurring monthly service fees, as well as any  additional services or service upgrades, that I request on my account, and any applicable usage charges. The registrant information of my PayPal account is: Account Holder: _____________ _ ___________ Phone # ___________________Street Address* :_____________________________________________________ City ____ _________ State _________ Zip/Postal Code _______ Country _______ * Must be registered shipping address listed on your PayPal account. I understand that this information will be used for purposes of verification with the  PayPal system to prevent fraudulent usage. Please note: If your PayPal registered email address changes, or if you wish to  utilize a different PayPal account than listed on this form, you will need to complete

and provide to Host NIT Inc ® a new PayPal Authorization Form.  You must attach a legible copy of your Driver’s License (or other valid photo ID: Passport, Gov’t Identification, etc...) and a legible copy of a utility bill which was received at your registered PayPal shipping address. Please Note: We accept bills other than utility bills but they must match your PayPal address.

 

Printed Name: ___________________________________Signature: ______________________________ Date: _____/_____/_____

 

Account Identifier : ___________________________________

(ie;

Order Tracking

# / Invoice #

/ Account #

PAYPAL AUTHORIZATION FORM

Please fax back to: 904-779-3323

ATTN

:

BILLING DEPT

Or

Send via Email w/attachments to auth@hostnit.com

 

PLEASE MAKE SURE TO PROVIDE ALL DOCUMENTATION REQUIRED.

Exception: If your Name and address match your name on the account, the only one identification is required. I.E: Drivers License.

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