Signing example
Sign a credit card authorisation form online
A credit card authorisation form has to prove the cardholder agreed to recurring charges up to a stated limit, without the form itself becoming a copy of the card. This one page authority for a coworking membership caps charges at $500 a month and asks the cardholder to type only the name on the card and its last four digits, behind an emailed code.
The document, with its fields
The pages as a signer sees them, with the signature, name, title and date fields placed where each party has to complete them.
Credit Card Authorisation
This form authorises Copperleaf Coworking Pty Ltd, ABN 15 662 094 870, of Level 2, 88 Hindley Street, Adelaide SA 5000 (Copperleaf), to charge the card described below for the membership of Wren and Hollis Design Studio, member account CW-3051, held in the name of the cardholder who signs this form.
What may be charged
| Charge | Amount and timing |
|---|---|
| Monthly membership, two dedicated desks | $420.00 including GST, on the 1st of each month |
| Meeting room hours above the 6 included | $22.00 an hour including GST, added to the next monthly charge |
| Monthly ceiling | No more than $500.00 in total in any calendar month |
Anything that would take a month's total above $500.00 is invoiced separately and is not charged to the card without a new authorisation from the cardholder.
Where the card number is kept
Terms of the authority
- The cardholder may cancel this authority at any time by email to billing@copperleaf.example. Cancellation takes effect for charges after the next business day and does not end the membership, which has its own 30 day notice.
- A disputed charge is raised with Copperleaf first. The cardholder keeps any right to dispute a charge with their card issuer.
- When the card is replaced or expires, the cardholder updates it on the gateway page. The authority continues for the new card with the same name, and the last four digits on file are updated by the gateway.
Authorisation
I authorise Copperleaf Coworking Pty Ltd to charge the card ending in the four digits above for the amounts described on this form, up to $500.00 in any calendar month, until I cancel this authority in writing.
Who signs what
- Nadia Hollis, cardholder
- Name on card and the card's last four digits, typed · Signature and stamped date under the authorisation · Verified by an emailed six digit code
The signing journey
Step 1
Four fields, none of them a card number
Two text fields labelled Name on card and Last four digits, then a signature and a date under the authorisation sentence.
Step 2
A code before the page
Her link opens a verification card. A six digit code goes to her inbox, lasts ten minutes and can be used once.
Step 3
She types 4417 and nothing more
The caption under the second line says last four digits only, and the box above it explains the full number goes on the gateway's secure page instead.
Step 4
Signed and certified at once
As the only signer, her finish completes the envelope. The certified PDF goes to her and to Copperleaf, with the certificate as a separate download.
Every field, and who fills it
Nadia Hollis fills all four fields. She types the name exactly as it appears on her card into the first text field and the four digits from the end of the card into the second, both on ruled lines in the middle of the page. Under the authorisation sentence she draws her signature, and the date beside it is stamped by the product, never typed. Copperleaf Coworking types nothing: its ABN, the member account CW-3051, the $420 membership, the $22 hourly rate and the $500 ceiling are printed before upload.
How to adapt this envelope
A one off authorisation, such as a hotel deposit, replaces the monthly ceiling with a single amount and date. A company card adds a company field so the cardholder types the business name. A provider that needs a second person on a shared account to agree can add them as a second recipient with their own signature, and leave Sign in order off because neither depends on the other.
Keeping card data off the document
Under the Australian Privacy Principles a business must take reasonable steps to protect the personal information it holds, and card schemes expect full card numbers to live only in systems built to store them. This form follows that by sending the cardholder to the gateway's hosted page for the card itself and keeping only a matching reference on paper. The signed PDF can then be filed with the member record like any other contract.
What makes this signing flow work
The form never holds a usable number
A signed PDF is emailed, stored and forwarded. If it carried a full card number and expiry, every copy would be a security problem. Here the only card detail on the page is 4417, which matches the gateway's stored card without letting anyone charge it.
The ceiling is on the signed page
Membership of $420 and meeting room hours at $22 are listed, but the line that matters is the bold monthly ceiling of $500. It sits above her signature, so a charge over that amount is plainly outside the authority.
A code ties the authority to her inbox
An authority to charge a card should come from the cardholder, not whoever holds the email. The emailed code makes her prove access to her own mailbox first, and the certificate records that method with her IP address and consent time.
Questions people ask
Is a credit card authorisation signed online enforceable?
In Australia, an electronic signature is recognised under the Electronic Transactions Act 1999 where the method identifies the signer and shows intention, and the other party agrees. Whether a disputed charge is reversed is decided by the card issuer under scheme rules, where a signed authority with a clear ceiling helps the merchant.
Why ask for the last four digits at all?
They let the business match this authority to the card stored on its payment gateway, which shows only the last four digits and the card type to staff. Without them, a member with two cards on file could argue the authority covered the other one.
Could the cardholder type the full card number by mistake?
The field is a plain text box, so in principle yes; the label and caption both say last four digits only. If it happened, the completed envelope could not be voided or edited, so the business would ask for a new authority and deal with the stored copy under its own data security policy.
Can she sign this on her phone?
Yes. Under 560 pixels wide the portal moves both text fields into a Complete your details panel above a read only view of the page. She enters the code, types the name and four digits there, draws her signature and accepts the electronic signing consent.
What does the certificate record for a single signer?
The envelope id, sent and completed times, one signer, the certification algorithm and both document hashes, then her verification method, signing time, IP address, consent time and version, and the hash of her signature image, followed by the event log. Card details never appear on it.
What if the cardholder declines?
The envelope moves to declined and Copperleaf is emailed with any reason she typed. No authority exists, so the membership is invoiced for payment by bank transfer instead. Copperleaf can void the declined envelope and send a corrected form if she asks for a lower ceiling.
Build your own in about a minute
The button below opens the generator with this use case already described. Change the wording to match your own, generate, then edit anything you like.
Make one like thisOther signing examples
Sign a family loan agreement online
A family loan agreement exists to prove, years later, that the money was a loan and not a gift, and that everyone in the family agreed how it would be repaid. This three page agreement records a $40,000 interest free house deposit loan from two parents to their daughter, with a repayment table she initials and three signatures collected in any order.
Statement of account confirmation e-signature
A balance confirmation is only worth something to an auditor if it comes straight from the customer, says plainly whether the balance agrees, and names anything in dispute. Here a grocer's accounts payable lead confirms the $24,106.85 August closing balance on a packaging supplier's statement, notes the one queried invoice, and signs, with the certificate as the audit evidence.
Sign a direct debit authority online
A direct debit authority has to prove two things: that the person who signed it can operate the account, and that the BSB and account number on file are the ones they gave. This one page request for a swim school's fortnightly $86 fee has the account holder type all four account details and sign in one session, behind a six digit code sent to her own email.
Want the steps in the builder? Read Send a PDF for e-signature, then Send a document for signature. For everything this generator can do, see the signing flow maker.
Written and checked by the OneCraft team. Last checked .