I authorize H-Authentica to charge my credit card for the goods/services described. I confirm that I am the authorized holder of this credit card and that the billing information provided is accurate.

I understand that this authorization will be used primarily for H-Authentica transactions. Additionally, I consent to H-Authentica keeping my credit card information on file as a backup payment method. If any pre-authorized debit (PAD) payment does not go through, H-Authentica is authorized to charge my credit card for the amount due for future transactions.

I agree to notify H-Authentica immediately in case of any changes to my credit card information or if I suspect any unauthorized use of my card.