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Payment Authorization Form
Jamestown RV Storage now offers an automatic payment option. With this option, your monthly payment will automatically be withdrawn from your checking account or your credit card account. This service is optional and you can mail in your payments by check or money order, rather than have it automatically charged.
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Indicates required field
Billing Options (select one)
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Option 1: Charge my credit card
Option 2: Charge my bank account (an image of a voided check must be uploaded below to initiate this option)
Required Information for Option 1: Charge my credit card
Type of Credit Card:
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Visa
Mastercard
Discover
American Express
Credit Card Number:
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Expiration Date:
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Credit Card Billing Address
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Line 1
Line 2
City
State
Zip Code
Country
Required Information for Option 2: Charge my bank account
Bank Routing Number
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Checking/Savings Account Number
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Upload an image of your voided check (Only use if you have selected: Charge my bank account)
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Max file size: 20MB
Personal Information:
Name
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First
Last
Cell Phone Number
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Home Phone Number
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Your Physical Address
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Line 1
Line 2
City
State
Zip Code
Country
Email
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Space Number at Facility (If unknown, will be filled in by staff)
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I authorize the management of Jamestown RV Storage, to charge my checking account or credit card specified above for charges incurred on the unit numbers listed above on the 1st day of each month.
I also understand that I may terminate this agreement by giving notice to the Jamestown RV Storage. I may do this at any time in writing, but must allow a reasonable amount of time after receipt for Jamestown RV Storage to act upon it. I also understand that additional service charges may apply if payment is returned due to insufficient funds.
Please enroll my account(s) in the AutoPay Program which I have selected.
Date
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By checking this box I agree to all terms and conditions of being enrolled in autopay stated above.
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I agree
Submit