Initial here to authorize automatic monthly charges:_____________
Type of Invoice:_____________________________________________
I hereby authorize the InterMedia Publications, Inc. to charge the amount shown above to the card specified above. In addition, if I have initialed the automatic payment section above, I authorize InterMedia Publications, Inc. to charge my card during the first week of each month for all fees due that month for the services I have subscribed to, until I notify them otherwise in writing. I understand that the fees due will include the regular monthly fees for that month, and may include additional usage fees from the previous month. I also understand that the first charge placed on my card will include the balance already due on my account, if any. I agree to pay the above credit card charges in accordance with the Card Issuer Agreement.
I understand that InterMedia Publications, Inc. will automatically add a 5% processing fee to all charges of $5000.00 or more. I understand that InterMedia Publications, Inc. will apply a chargeback fee to my account ($250.00 US as of the time this is written), if I initialize a chargeback with my credit card issuer, to reverse payment without InterMedia Publication Inc. providing permission I agree to pay the chargeback fee if this occurs.
InterMedia Publications, Inc. 380 S SR434 Suite # 1004-283 Altamonte Springs, FL, 32714 United States of America. Phone: (407) 745-1516 Fax: (407) 295-1664
