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Credit Card Authorization for Rent/Security Deposit
for Boardwalk Realty & Development

Please use this form to send in your deposit, pay your rent, or to give general comments.  Make certain to identify in the comments section of this form the apartment that you are making payment for (for example Beachcomber unit 255-12)

  1. Please provide the following contact information:

    Name
    Street Address
    Address (cont.)
    City
    State/Province
    Zip/Postal Code
    Work Phone
    Home Phone
    FAX
    E-mail

  2. Payment

    		 Deposit         Rent

    Amount

    		 Example$650.00

    BILLING
    Credit Card
    Cardholder Name
    Billing Address
    State
    Zip
    Card Number
    Expiration Date

  3. Enter the date of  today

    -- mm/dd/yy

  4. Enter the time

  5. Comments

    Please check all information before hitting the submit button.  Make certain to identify in the comments section of this form the apartment that you are making payment for (for example Beachcomber unit 255-12)

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Copyright © 1999 [Boardwalk Realty]. All rights reserved.
Revised: March 31, 2008