CREDIT/DEBIT CARD AUTHORIZATION FORM Please select one service below.(Required) AUTOMATIC BILLING AUTHORIZATION PHONE ONLY AUTHORIZATION Authorization for Automatic BillingI authorize Silverado Self Storage LLC to keep my signature on file and to charge my credit card account listed below for charges incurred in connection with the storage space listed below. I understand such charging for rental payments on the space will be charged on the rental due date and/or contract date of each month, beginning with date selected below and ending when I vacate my space or cancel this agreement. Other incidental charges will be transacted as they occur. I also agree to hold Silverado Self Storage harmless from liability as a result of its activities in connection with such transactions. I understand that this form is valid until I cancel the authorization thirty (30) days prior to vacating through written notice to: Silverado Self Storage Located at: 5100 Las Brisas Blvd., Reno, NV 89523Starting Date MM slash DD slash YYYY Authorization by Phone OnlyI authorize Silverado Self Storage LLC to keep my signature on file and to charge my credit card account listed below in the event I may call and ask the management to do so. Customer's Name(Required) First Last Cardholder's Name If Different First Last Silverado Space NumberCard Holder's Billing Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Type Last Four Digits of Your Credit Card NumberCredit Card Type(Required) Master Card VISA AMEX Discover Card Card Expiration Date MM slash DD slash YYYY Card Holder's SignatureDate MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged. Δ