Payment Authorization

Recurring Credit Card Payment Authorization

I, the undersigned individual, hereby authorize Plaquemines Parish Government (the “Marina”) to regularly scheduled charges to my default payment method shown below, or my chosen default payment method selected on the marina’s payment portal. I also agree that the Marina and its third-party service providers providing payment processing services may store my payment information. I acknowledge and agree that if charges are paid via ACH that there are no additional fees associated with my payment. However, I will be charged the amount indicated below each billing period if my payment choice is by credit card, which shall include the cost for the services provided by the Marina, all applicable taxes, and 2.95% for Visa, Master Card or Discover, and 3.50% for American Express.

In the event that I previously provided the Marina with my payment information, I acknowledge and agree that the Marina and its third-party service providers providing payment processing services are and have been previously authorized to regularly charge my credit card and store my payment information. A receipt for each payment will be provided by the Marina and the charge will appear on my credit card statement. I agree that no prior notification will be provided unless the date or amount changes, in which case I will receive notice from the Marina at least 10 days prior to the payment being collected.

I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify the Marina in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. If the payment method I provided to the Marina reaches its expiration date and I do not edit the applicable information or cancel such services, I authorize the Marina to continue billing that payment method and that I will remain responsible for any uncollected amounts. I agree to reimburse the Marina for all collection costs and interest for any overdue amounts. I acknowledge that the origination of credit card transactions to my account must comply with the provisions of U.S. law. I certify that I am an authorized user of the credit card or bank account information provided to the Marina and will not dispute these scheduled transactions; so long as the transactions correspond to the terms indicated in this authorization form.

Token Check Failed