Holland Pool Service


60 Asbury Road Suite 1000 Hackettstown, NJ 07840



Credit Card Authorization Form

Phone: 908-684-9329


Fax: 908-684-9328


Toll Free: 877-654-7665


www.hollandpool.com


In consideration of Holland Pool Service accepting my credit card number as guarantee of payment for services and materials, I agree to the following:
Holland Pool Service has the right to charge to my valid credit card any required deposits or balance of services upon completion unless prior arrangements are agreed upon regarding payment of account.
Holland Pool Service agrees to provide me with a written invoice detailing any charges posted to my credit card account at the time of billing.

ALL CUSTOMERS MUST PROVIDE OUR COMPANY WITH A VALID CREDIT CARD. WE RESERVE THE RIGHT TO BILL ANY UNPAID BALANCE TO YOUR CREDIT CARD ON FILE.

No customer credit information will be stored on our computers. All credit information will be provided to our secure merchant processor. It will remain accessible to us for future billing purposes as authorized by our customers.

Holland Pool Service respects the privacy of our clients and will not disclose any individual or credit information to any business or organization for any purpose.

Please return this form via email, mail or fax to Holland Pool Service at 908-684-9328. If you have any questions regarding this form or about any of our services, please feel free to contact our office. Thank You


Customer Signature: Date:

The Holland Pool Service is a Licensed and Insured Home Improvement Contractor HOL #13VH06212700 ~ New Jersey Division of Consumer Affairs ~ 1-888-656-6225