Credit Card Authorization Form

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TO: Cape Fear REALTORS®, and/or its Multiple Listing Service Corporation and/or its RCA Division and/or the Wilmington REALTORS® Foundation.

I, Full Name as Appears on Card, hereby authorize Cape Fear REALTORS® Inc. and its Multiple Listing Service Corporation and/or its RCA Division to charge my credit card account as designated below:

Applicant First Name

Applicant Last Name

Applicant Firm Name

Applicant Email

I acknowledge my responsibility to notify Cape Fear REALTORS,® Inc. its Multiple Listing Service Corporation and/or its RCA Division in writing of any change or cancellation of this service.

I hereby waive my right to sign an individual sales slip for each charge to my credit card

Card Type

Visa MasterCard

Name as Appears on Card

Credit Card #

Expiration Date

CID #

Is your card

Personal Corporate

If this card is for additional members, please specify here

Please Select One

All charges for all invoices due to the MLS and/or the RCASENC and/or Cape Fear REALTOR® (including charitable foundation; REALTOR® Store charges; education classes; events; key access; annual dues; political action committees (PAC) etc) All charges for all invoices due to the MLS and/or the RCASENC and/or Cape Fear REALTOR® (including charitable foundation; REALTOR® Store charges; education classes; events; key access; annual dues; etc Start-Up Fees ONLY

Today's Date

By checking this box, I indicate that I have read and agree with the items stated above