Intercity Lines Payment Authorization Form

Please fill out the fields & sign below if paying with a credit card. – 800-221-3936 – – P.O Box 1299 Warren, MA

Credit Card Payments can be made using a Visa or MasterCard. 
We do not accept American Express or other cards. We do not accept payment from 3rd parties. 

Name on Credit Card:    


Phone Number:   


Year, Make, & Model of the Vehicle being Transported:   

Pick Up City & State:   

Delivery City & State:   

Cost of Transport:   

Billing Address:   

For your security, we will call you for your credit card #. We typically run Credit Card payment’s once pick up has been scheduled 2-3 days before. 

I, the cardholder, authorize Intercity Lines, Inc to charge my Visa or Mastercard for payment of the vehicle transport described above.

Leave this empty:

Intercity Lines
Signature Certificate
Document name: Intercity Lines Payment Authorization Form
Unique Document ID: 67601e924f92310acbbc315c06b9888c22f46cec
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October 26, 2018 11:28 am ESTIntercity Lines Payment Authorization Form Uploaded by intercity lines - IP