Autopay Payment Authorization/Update
Please use this form to sign up for Autopay, or to provide an updated credit or debit card for your existing payment plan.
This should be the adult name on your Rental Account
State / Province / Region
Postal / Zip Code
Please enter the address that is on file with the card.
Cardholder Phone Number
This will be used for future receipts
Account Number(s) if known
Your account number a 5 digit number that may appear on receipts
I am on Autopay, and need to update my card information
Please enroll me in Autopay with the card provided below
If payment is due, the card provided will be used to charge all payments due.
Please provide payment details below
Accepted Payments: Visa, Mastercard, Discover, American Express
What is this?
3 or 4 digit number printed on the back/front of your credit card
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Data collected via fields that have our security seal are encrypted and stored with the highest global security standard — PCI compliance. Your data is absolutely safe in Vault.
I do authorize
As named Cardholder; I Authorize: ***David French Music*** to charge my card each month for rental payments. I understand that this payment will continue until I own the instrument, cancel my rental agreement with DFMC, or contact DFMC to discontinue Autopay.
Use the mouse or your touchscreen to sign