One Off Sale – KIS Corporate

One Off Sale Payment

Name*
First Last
Address*
Street Address City State Post Code
Email*
Phone*
Contact that you have been dealing with at KIS*
Card Information
Card Type*
- Visa
- Mastercard
- AMEX
Click here. to view current card surcharges
Cardholder Name*
Card Number*
Expiration Date*
Security Code*
CVV on back of card
Authorisation Date*
MM slash DD slash YYYY
Confirmation of Authorisation*
- I authorise KIS Transport Pty Ltd or KIS Corporate Pty Ltd to charge the credit card indicated in this authorisation form according to the terms outlined below. This payment authorisation is for the goods/services for KIS Transport or KIS Corporate 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.
Terms & Conditions*
I have read and I accept KIS Group of Companies Terms & Conditions
Additional Fees*
I confirm I understand that if any additional charges are incurred these will be charged to my nominated Credit Card.
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