Friendly Neighborhood Help

Secure Online Payment Center

This is our Automatic Credit/Debit Card authorization form. You can Pay online using our secure system. When we start service we will automatically bill your credit/debit card for the amount indicated and your total amount will appear on your monthly statement.

Note: all information provided is secure.

You can either sign up online or fill out the form that was given to you with your evaluation papers.

If you have a one time service to be performed by us your card will only be billed once and will not be put on our automatic payment plan.

*Taxes may apply according to State Regulations

AUTOMATIC CREDIT/DEBIT CARD AUTHORIZATION FORM

NAME AS IT APPEARS ON CREDIT/DEBIT CARD:

CREDIT CARD TYPE:

CREDIT CARD NUMBER: (NUMBERS ON FRONT OF CARD)

EXPIRATION DATE:

SECURITY CODE ( 3-4 DIGIT CODE ON BACK OF CARD):

CARDHOLDER'S BILLING ADDRESS (STREET,CITY,STATE,ZIPCODE):

I GIVE THE RIGHT TO FRIENDLY NEIGHBORHOODHOOD HELP LLC. TO AUTOMATICALLY CHARGE CREDIT/DEBIT CARD AFTER SERVICE HAS BEEN PERFORMED:

YES
NO

I CERTIFY THAT THE ABOVE STATEMENTS AND INFORMATION MADE IN THE AGREEMENT ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I ALSO CERFTIFY THAT I AM AUTHORIZED TO EFFECT CHARGES TO THE ABOVE CRFEDIT /DEBIT CARD NUMBER. IN THE CASE OF ANY ISSUES OR DISPUTES CONCERNING THIS TRANSACTION I WILL NOTIFY FRIENDLY NEIGHBORHOOD HELP LLC. PROMPTLY TO RECTIFY THE SITUATION PRIOR TO NOTIFYING MY CREDIT CARD COMPANY.

We accept all major credit/Debit cards

Friendly Neighborhood Help LLC ~Servicing: Cleveland,Akron,

Phone: 1-877-331-6188 Email: contact@friendlyneighborhoodhelp.com