EmailMeForm
Date
*
MM
/
DD
/
YYYY
Project type:
Feature Film
Television
Commercial
Special Event
Other
COMPANY / CARDHOLDER INFORMATION
Company Name
*
(MUST match company name on COI)
Cardholder Name
*
First
Last
Email
*
Phone
*
###
-
###
-
####
Billing Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
NOTE:
The company providing the COI is responsible for providing payment.
We cannot accept payment from a 3rd party company.
CREDIT CARD INFORMATION
Type of Card:
*
VISA
MASTERCARD
AMEX
OTHER
Credit Card
*
Card Number
Expiration
MM
/
YY
CVV
What is this?
3 or 4 digit number printed on the back/front of your credit card
Protected in vault
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.
SELECT ONE:
*
Keep on file as default payment for future orders/projects (one card per account)
Only for use on this job:
CREDIT CARD AUTHORIZATION
Thank you for choosing Green Set! As a C.O.D. Client, your credit card will be charged for your full order total upon pick up or 1 business day prior to your delivery.
*
I authorize Green Set, Inc. to use this Card for payment of Purchases, Rental charges, Late charges and/or Loss & Damage charges for the Plants, Props or Set Dressing rented or purchased from Green Set, Inc.
*
In the event that the Plants,Set Dressing and/or Props are Not Returned on the Specified Date,or if the Plants,Props and/or Set Dressing are Lost & Damaged, I authorize Green Set, Inc. to charge the Credit Card in this form, for subsequent charges.
Signature
Clear
Cardholder Name:
(Please Print)
Today's Date
MM
/
DD
/
YYYY
