Skip to content
Pool Drain Waiver
1-480-440-7662
1-480-440-7662
Pool Services
Repair & Installation
Filter Cleaning
Tile Cleaning
Schedule Service
Pay Online
Menu
Credit Card Authorization Form
Please complete all fields. You may cancel this authorization at any time by contacting us. This authorization will remain in effect until cancelled.
Card Type
*
VISA
MasterCard
AMEX
Discover
Cardholder Name (as shown on card)
*
Card Number
*
Card Number
*
Security Code
*
Expiration Date (mm/yy)
*
Cardholder ZIP Code
*
(From credit card billing address)
Agreement…
*
By checking this box, I authorize Twelve Pool Service, LLC to charge my credit card above for agreed upon purchases. I understand that my information will be saved on file for future transactions on my account.
Customer Name
*
First
Last
Customer Signature
*
Reset signature
Signature locked. Reset to sign again
Use your mouse (computers) or finger (mobile touch devices).
Δ
Pool Services
Repair & Installation
Filter Cleaning
Tile Cleaning
Schedule Service
Pay Online