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Credit Card Authorization Form Template for Belgium

A standardized legal document compliant with Belgian and EU regulations that authorizes a merchant to charge a specified credit card for goods or services. This form incorporates requirements from the EU Payment Services Directive 2 (PSD2), GDPR data protection requirements, and Belgian financial regulations. It includes provisions for merchant identification, cardholder details, payment terms, data protection notices, and necessary authorization declarations. The document ensures secure transaction processing while maintaining compliance with Belgian consumer protection laws and EU payment service regulations.

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What is a Credit Card Authorization Form?

The Credit Card Authorization Form is a critical document used in Belgian business transactions to obtain formal permission from cardholders for processing credit card payments. It serves as a legal agreement between merchants and customers, enabling businesses to charge credit cards for one-time or recurring payments. This document must comply with Belgian financial regulations, EU Payment Services Directive 2 (PSD2), and GDPR requirements for data protection. It's particularly important for businesses operating in Belgium that need to process credit card payments securely and legally, whether for immediate transactions, recurring billing, or future authorized charges. The form includes essential elements such as cardholder information, payment details, authorization terms, and required disclosures under Belgian law.

What sections should be included in a Credit Card Authorization Form?

1. Cardholder Information: Complete details of the cardholder including full name, billing address, and contact information as required by Belgian financial regulations

2. Merchant Information: Details of the business/merchant receiving the authorization, including legal business name, registration number, and contact details

3. Card Details: Secure section for credit card information including card type, number (typically last 4 digits only), expiration date, and security code fields

4. Authorization Terms: Clear statement of the authorization being granted, including payment amount(s), frequency, and duration of the authorization

5. Data Protection Notice: GDPR-compliant disclosure about how card and personal data will be collected, processed, stored, and protected

6. Security Declarations: Statements confirming the cardholder's authority to authorize payments and the truthfulness of provided information

7. Signature Block: Space for cardholder signature (physical or electronic) and date, meeting Belgian electronic signature requirements

What sections are optional to include in a Credit Card Authorization Form?

1. Recurring Payment Details: Include when authorization is for recurring payments, specifying payment schedule and total number of payments

2. Maximum Charge Limit: Add when there's a need to specify maximum transaction amounts or periodic charging limits

3. Cancellation Rights: Include for consumer transactions to detail the right to cancel and cancellation procedure

4. Multiple Card Authorization: Add when authorization covers multiple cards or backup payment methods

5. Third Party Authorization: Include when someone other than the cardholder is authorized to use the card

What schedules should be included in a Credit Card Authorization Form?

1. Payment Schedule: Detailed breakdown of payment dates and amounts for recurring payments

2. Privacy Policy: Detailed GDPR-compliant privacy policy regarding payment data handling

3. Terms and Conditions: Complete terms and conditions of the credit card authorization

Authors

Alex Denne

Head of Growth (Open Source Law) @ 黑料视频 | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents

Jurisdiction

Belgium

Publisher

黑料视频

Document Type

Authorization Form

Cost

Free to use

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