Credit Card Authorization for Service Work

Boat Name(Required)

Boat Location & Slip Number(Required)

For the safety of our technicians, all vessels must be securely docked. We do not perform service on vessels that are underway or on a mooring.

Boat Make/Model/Year(Required)

HIN (Hull Identification Number)

A service technician will verify this number once on board

Briefly detail what service(s) are needed(Required)

Billing Responsibility(Required)

Boat Owner

Captain

Management Company

To protect all parties and ensure accurate billing, we require the full name and contact details for the vessel’s legal owner. Captains or managers may still handle payment and coordination, but owners must be listed in our records.

Billing Responsible Party Details (Required)

*This is the person who will receive the invoice and be charged if no other payment is provided within 10 days of job completion.

Billing Responsible Party(Required)

First Last

Business Name (If Applicable)

Phone(Required)

Email(Required)

Billing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Boat Owner Information (Required)

Please list the legal owner of the vessel, even if a captain or manager is handling scheduling and payment. This is required for our records.

Name(Required)

First Last

Phone(Required)

Email(Required)

Captain Information (Optional if not applicable)

Name

First Last

Phone

Credit Card Type

Visa

Master Card

American Express

Name on Credit Card(Required)

First Last

Credit Card Number(Required)

Expiration Date(Required)

CVV(Required)

Digital Signature (Type Name)(Required)

Upload Card Holder's ID & Card(Required)

Max. file size: 256 MB.

Please upload a photo or scan of your legal identification card (e.g., license, state ID, or passport) and the card being used.

Credit Card Authorization for Service Work