Customer Information

We apply a surcharge on card transactions that does not exceed our cost of acceptance

One (1) Time Credit Card Payment Authorization

Sign and complete this form to authorize Dakota Financial, LLC to make a one-time charge to your card listed below.

Billing Information

  • Card Type:

By clicking Submit Payment button you authorize Dakota Financial, LLC to charge the card indicated in the authorization form according to the terms outlined above. This payment authorization is for the goods/ services described above, for the amount indicated above only, and is valid for one (1) time use only. I certify that I am an authorized user of this card and that I will not dispute the payment with my Credit/Debit card company; so long as the transaction corresponds to the terms indicated in this form.

For any queries contact us:

Customer Service Phone Number: 310-696-3030
Customer Service Email: customerservice@dakotafin.com

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