Automatic Credit Card Billing Authorization Form

Please complete the following information and check the box below:

Monthly dues as specified in your CIN Affiliate Agreement.

Name *
Billing Address *
Billing Address
I authorize and allow CAZA Investor Network to charge my credit card account listed above for the monthly amount due CAZA Investor Network for my Affiliate Partner dues. I agree that each charge to my account shall be the same as if I had signed a check to pay my bill. This authority will remain in effect until I notify CAZA Investor Network in writing otherwise. If I change the credit card institution specified, I will provide written authorization for the new credit card institution to CAZA Investor Network immediately. In addition, I have the right to stop payment of a charge by notifying CAZA Investor Network at least 72 hours before the account is charged. I understand that CAZA Investor Network reserves the right to terminate this payment plan and/or my participation therein. *