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Please fill in the information below for the processing of your credit services.


TLS Credit Services Client Info:
First Name:*
Last Name:*
S.S.N:*
DOB:*
Email:*
Phone:*
Address:*
City: *
State:*
Zip/Postal Code:*
   
Credit Card Details

Sign and complete this form to authorize TLS Credit Services to make a debit to your credit card listed below. By signing this form you give TLS Credit Services permission to debit your account for the amount indicated on the agreement by TLS Credit Services. This is permission for a single transaction or recurring payments depending on service package selected.

Credit Card No :*
Expiration Date:*  
Card Verification Value:*  
Billing Zip Code :*
   
   
   
Digital Signature:*   
   
   
 
Choose Package

Premier

$199 PERFORMANCE FEE
$99USD/MONTHLY
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ULTIMATE PROFESSIONAL

$299 PERFORMANCE FEE
$125USD/MONTHLY
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Platinum Diamond

$399 PERFORMANCE FEE
$199USD/MONTHLY
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Custom agreement

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Authorization

TLS Credit Services is here by authorized to charge the indicated credit card on a recurring basis for payment for services performed by TLS Credit Services. In the event of cancellation of service, I authorize TLS Credit Services to subsequently charge any credit card in my recurring credit card authorization agreement for payment of all charges of services performed by TLS Credit Services. I agree to inform TLS Credit Services of any change (including expiration date) in my credit card information, which may be required in writing. I guarantee and warrant that I am the legal cardholder for this credit card and that I am authorized to enter this recurring billing agreement. I agree that termination of this recurring credit card authorization ends when all balances are paid in full for services rendered by TLS Credit Services.