One Time Credit Card Payment Authorization Form

All Information Will Remain Confidential

  • I authorize Uvoice USA, LLC to charge my credit card account in the amount and on the date indicated below:


    I understand that this credit card service is provided as an alternative payment option.


    CC Information:

  • (3 digit number on back of Visa/MC, 4 digits on front of AMEX)

  • Consent:

  • MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.