Card Charge Authority Form

Complete this form so we can charge the debit or credit card you'll read to us over the phone. You can sign electronically below, or , wet-sign it, and email the scan to hire@tridenttaxis.com.

Your card number is never entered on this page

For PCI-DSS compliance, we take the full card number over the phone on a recorded line and process it directly through Stripe or Worldpay. This form only files the cardholder's written authority to charge the stated amount.

Full name on card *

Contact phone *

Billing address *

Postcode *

Email *

Amount to charge (£) *

Booking reference (if known)

Card brand (optional)

Card last 4 digits (optional)

Charge authority *

CARD CHARGE AUTHORITY — TRIDENT TAXIS / NATIONAL TAXI NETWORK I, the cardholder named below, authorise Trident Taxis (trading as National Taxi Network) to debit the payment card whose details I will provide by telephone for the amount stated on this form. I confirm that: 1. I am the legal cardholder and the card details I supply by phone are accurate and belong to me. 2. The amount to be charged is a one-off transaction for the taxi or private-hire service booked in my name, or against the booking reference recorded below. 3. Trident Taxis will only charge the amount authorised on this form. Any additional charge (e.g. waiting time, extra stops, tolls) requires a separate written authorisation from me. 4. I understand that Trident Taxis does not store my full card number. Card details are captured over the phone through a PCI-DSS compliant telephone payment process and are transmitted directly to our payment processor (Stripe / Worldpay). 5. This authority remains valid for 30 days from the date signed, after which it expires and a new authorisation is required. 6. I have read and accepted the Trident Taxis terms of service and privacy notice (available at /terms and /privacy). Signed as an electronic or wet signature and filed with Trident Taxis for audit and chargeback protection purposes.

I am the cardholder and I authorise Trident Taxis to charge the amount stated above to the card details I will provide by telephone, subject to the terms of this authority.

Digital signature *