I authorise the above named business to charge the credit card indicated in this form according to the terms outlined above. This payment authorisation is for the goods/services described above, for the amount indicated above only, and is valid for one time use only. I certify that I am an authorised user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated in this form. There will be 2% additional surcharge for credit card payments except American Express (AMEX) which will have a surcharge of 3%