NYMail Virtual Office mail receiving on 5th Ave New York

AUTO-PAYMENT FORM

244 Fifth Avenue . 2nd Floor . New York, NY 10001
Phone : (212) 679-0000 Fax : (212)591-6000
www.nymail.com email: service.nymail@gmail.com

I agree to authorize Aerobeep & NyMail Services,Inc to automatically bill my credit card periodically for Mail Receiving/Voicemail/Fax Services.I recognize that this Auto Bill program does not include typical credit card chargeback rights and procedures and that I will contact Aerobeep directly concerning Billing disputes.

Amount to be charged :

Account Number :

Name (as it appears on the card):

Email:

Address (billing address of the credit card):

City*

Zip Code *

Country*

State*

Circle Card Type: Master Card Visa American Express Discover

Credit Card Number:

Exp. Date:

CVV Code:

Master Card, Visa & Discover, the CVV code is printed on the back of your card.It's the last 3 digits.American Express the CVV code is printed on the front right side of the card and is 4 digits.

Drivers Licence # or Other ID # :

Please Enclose a copy of your Drivers Licence or Picture ID

Signature:

Date:

AUTO PAY

AUTO-PAYMENT FORM

Please Enclose a copy of your Drivers Licence or Picture ID

Hours