Authorize Users to Credit Account

Complete the form below to authorize or un-authorize users to utilize your credit account with Ameritone Maui. If you provide an email address in the form you will receive a confirmation email of this authorization for your records. You may also upload a list, fax, email, or call in your requests as well.

If you prefer to download a credit card authorization form, you may obtain it here.

Your Name (required)

Your Email (required)

Account Name/Number

Authorized Users





Unauthorized Users





Additional Notes

THIS AUTHORIZATION TAKES PRECEDENCE OVER ANY PRIOR SUBMISSIONS.

File Upload

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