Recurring Payment Authorization - Pioneer Energy Management 2026

1. Click ‘Get Form’ to open the Recurring Payment Authorization in the editor.
2. Select your payment type by circling either VISA, MASTERCARD, DISCOVER, or AMERICAN EXPRESS.
3. Enter your card number in the designated field and provide the expiration date in the format MM/YYYY.
4. Input the security code: for VISA/MC, it’s the 3 digits on the back; for AMEX, it’s the 4 digits on the front.
5. Indicate if this is a company card by circling YES or NO. If YES, fill in both the company name and individual’s name as it appears on the card.
6. Complete the billing address fields including city, state, and zip code. If different from your company address, provide that information as well.
7. Fill in your office phone number and fax number if applicable.
8. Provide your name and call back phone number for any follow-up communication.
9. Sign and date at the bottom of the form to authorize charges.

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