Air Quality Credit Card Authorization Form (PDF) - Broward County 2025

1. Click ‘Get Form’ to open the Air Quality Credit Card Authorization Form in the editor.
2. Begin by selecting the appropriate fees you wish to authorize payment for, such as Asbestos Fee or Air License Fee. Clearly indicate the total amount to be charged in the designated field.
3. Fill in your cardholder information, including your name as it appears on the card, mailing address, and phone number. Ensure accuracy to avoid processing issues.
4. Enter your credit card details: number, expiration date, and card verification number. Select your card type from Mastercard, VISA, American Express, or Discover.
5. Sign and date the form at the bottom. Print your name and title clearly for verification purposes.
6. Complete any additional fields related to your company name and project/application description before submitting.
7. Once completed, save your form and either email it to AirLicense@Broward.org or mail it to the Environmental Engineering and Permitting Division at the provided address.

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