Legal Forms

Form DOS-1450 Credit Card Authorization

Form DOS-1450 Credit Card Authorization



A credit card authorization form is a business form used for providing the legal authority for a business entity to charge a consumer's credit card.  They are typically used in situations where the payment must be processed off site from where the consumer is located. 

In this case, we are using the credit card authorization form used by the New York state division of licensing.  Examples of other credit card authorization forms can be found online or through many businesses that accept credit cards.   

The first step in completing the form is to enter the information of the person or company that the payment is being made for. 

1. Include the last name, first name, and initial.  

2. Put the company name if the payment is being made on behalf of a company. 

3. If you have a unique I.D. Number, you would put that number on the bottom line in the identification box. 

The next section of the credit card authorization form requires your credit card information.

4. Make sure all of the information in this section corresponds with your credit card account information.  Put your billing name, address, and city and state that represent your card. 

5. Put the total amount of the payment that you are authorizing the New York licensing services to put on your credit card. 

In the last section, you must put your credit card information.  

6. Select the type of card, noting that they will only accept visa or master-card for credit card payment.  

7. Put the expiration date and the card number in the corresponding boxes.  

Finally, you will authorize the payment with your signature and the date in which you signed the form.  

8. The form is now ready to be sent to the agency.  Keep a copy of the authorization for your records.  

Download the PDF file .




Related Articles