Credit Card
Payment Authorization Form

This form provides you with the ability to submit your Credit Card information to make payments on your Inmarsat account. The information you provide on this form is encrypted for your security and is not stored on our web server.

All fields marked with an asterisk ( * ) are required fields and need to be completed to successfully submit this form.

SECTION A: CUSTOMER INFORMATION

* Customer name  
* Account number  
* Telephone number  
* E-mail address    
   

SECTION B: PAYMENT OPTIONS

Please choose one of the following options:
Option 1:
Invoices billed in currencies other than $US and $Canadian will use current exchange rates.
   
Option 2:
This option is available only to customers billed in $US and $Canadian currencies.

SECTION C: INSTRUCTIONS

Payment      
  Invoice # Amount Currency
     
 
 
 
 

SECTION D: CREDIT CARD INFORMATION

* Credit Card Number  
* Card Holder's Name  
* Credit Card Type  
* Expiry Date month   year  
   
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