BIGLIST Recurring Credit Card Billing Agreement

Use this form to authorize BIGLIST, Inc. ("BIGLIST") to set up recurring credit card billing for mailing list services that BIGLIST provides for you. Before automatic recurring credit card billing can begin, this form must be completed

Account Information		Billing Information

Account list domain:		Cardholder name:
Company:		Email:
		Card Number:
Contact Name:		Expiration Date:
Phone:		Security code:
Email:
		Billing Address:

		City, State & Zip Code:

I hereby authorize BIGLIST to charge the above-identified credit card for mailing list services provided by BIGLIST. I agree that this is a periodic charge that will be made according to my billing cycle, and in order to terminate the recurring billing process I must either cancel my account, or arrange for an alternative method of payment. I understand that BIGLIST will not mail me any invoices or bills.

I understand that all account cancellations for which an active recurring billing authorization exists must be made in writing to the address, BIGLIST Inc., 1640 Maple Ave #801, Evanston, IL 60201, or by email sent by the authorized primary contact or web administrator for the account to billing@biglist.com.

I agree not to dispute BIGLIST's recurring billing with my credit card issuer as long as the amount in question was for services rendered prior to cancellation of the account.

I agree that I will not dispute any charges from BIGLIST unless I have already made an effort in good faith to rectify the situation directly with BIGLIST, and those efforts have failed.

I agree to the terms and conditions set forth in the BIGLIST Customer Agreement, and I understand that I will forfeit any fees paid to date if my account is terminated as a result of a violation of the BIGLIST Customer Agreement.

I agree that any credits issued by BIGLIST for any reason will not be refunded to my credit card, but instead will be deducted from my next bill.

I authorize BIGLIST to run an address verification search. This verification process is a security measure designed to protect me, the client, from illegal fraud against my credit card.

I guarantee and warrant that I am the legal cardholder for this credit card, and that I am legally authorized to enter into this recurring billing agreement with BIGLIST.

REQUESTS TO TERMINATE AUTHORIZATION OF RECURRING BILLING MUST BE MADE BY EMAIL 15 DAYS PRIOR TO THE NEXT SCHEDULED PAYMENT TO: BIGLIST Billing <billing@biglist.com>.

Cardholder's Authorized Signature: ______________________________ Date: ___________________