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A-368 Form CC Credit Card Authorization

A-368 Form CC Credit Card Authorization

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Form CC Credit Card Authorization

I authorize the Government of Nunavut to charge my credit card for the amount of

as payment for fees due to the Office of the Superintendent of Licensing under the Cannabis Act (Nunavut).

Type of Credit Card

Credit Card Details

Alternative Payment
If the Government of Nunavut is unable to process my payment, I understand that I am responsible for arranging alternative payment.
Records
I understand the Government of Nunavut does not keep credit card information on file, and that it will destroy this form once it has successfully processed the payment.
Approval
I agree to this payment and warrant that I am authorized to do so.

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