QUACK PACK LLC
Rental Agreement, Damage Authorization, Payment Authorization & Liability Waiver
Agreement Version: QP-RA-2026-08-v1 Effective Date: August 16, 2026
This Rental Agreement, Damage Authorization, Payment Authorization and Liability Waiver ("Agreement") is entered into between Quack Pack LLC, a South Carolina limited liability company ("Quack Pack," "QP," "we," "us," or "our"), and the person or entity placing the reservation ("Customer," "you," or "your").
The reservation confirmation, selected package, number of bins and other Equipment, rental dates, delivery and pickup locations, pricing, add-ons, fees and other order-specific information presented during checkout or contained in the reservation confirmation are incorporated into this Agreement as the Order Summary.
By electronically accepting this Agreement and completing a reservation, Customer acknowledges that Customer has read, understood and agreed to this Agreement.
1. RENTAL OF EQUIPMENT
Quack Pack rents reusable moving and storage equipment, which may include plastic storage bins, lids, dollies and other reusable accessories identified in the Order Summary ("Equipment").
All Equipment remains the sole property of Quack Pack unless Quack Pack expressly agrees otherwise in writing.
No ownership interest in the Equipment is transferred to Customer by payment of rental, holdover, damage, loss or other charges described in this Agreement.
Customer may use the Equipment only during the agreed rental period and only for lawful purposes consistent with its intended use.
Customer may not sell, transfer, pledge, sublease, permanently alter, abandon or otherwise dispose of Quack Pack Equipment.
Quack Pack may substitute substantially equivalent Equipment when reasonably necessary because of inventory availability, provided the substitution does not materially reduce the quantity or basic functionality of Customer's rental.
2. RENTAL PERIOD
The rental begins on the delivery or possession date shown in the Order Summary and ends on the scheduled pickup or return date.
Customer agrees to have all Equipment completely emptied, reasonably clean, accessible and ready for pickup on the scheduled pickup date.
Equipment is considered returned only when it has been physically recovered by Quack Pack or returned to a location expressly authorized by Quack Pack.
If Customer timely makes the Equipment available for pickup but Quack Pack delays pickup solely because of Quack Pack's scheduling or operational needs, Customer will not be charged additional rental or holdover charges for that delay.
3. APPROVED EXTENSIONS
Customer may request additional rental time before the scheduled pickup date.
Extensions are subject to Equipment availability and Quack Pack's approval.
An approved extension may be priced at a rate separately quoted or disclosed by Quack Pack.
Quack Pack is not required to approve an extension and may require return of the Equipment when it has been committed to another customer or is otherwise needed for operations.
4. UNAPPROVED HOLDOVER
If Customer retains any Equipment beyond the scheduled rental period without an approved extension, fails to make the Equipment available for pickup, or otherwise prevents timely return, Customer will incur an Unapproved Rental Holdover Charge equal to 3% of the Package Rental Subtotal per calendar day.
For purposes of this Agreement, Package Rental Subtotal means the base rental charge for the selected bin package before logistics/delivery fees, add-ons, taxes and other charges.
The holdover charge begins after the scheduled return or pickup date and may accrue for a maximum of thirty (30) consecutive calendar days.
Holdover charges accrue daily but Quack Pack may process them periodically or as one accumulated charge rather than processing a separate payment every day.
Customer may stop future holdover charges before the thirty-day maximum by returning all Equipment or arranging an approved pickup and making all Equipment available to Quack Pack.
Accrued charges remain due even after Equipment is subsequently returned.
5. THIRTY-DAY PERMANENTLY UNRETURNED EQUIPMENT
If any Equipment remains unreturned for thirty (30) consecutive calendar days after the scheduled return date without an approved extension, Quack Pack may classify the remaining Equipment as Permanently Unreturned Equipment.
Upon that classification:
- Daily Unapproved Rental Holdover Charges stop accruing.
- All holdover charges already accrued remain due.
- Quack Pack may assess the applicable one-time Permanently Unreturned Equipment Charge shown in the Fee Schedule below for each item that remains unreturned.
- Payment of a Permanently Unreturned Equipment Charge does not constitute a sale of the Equipment or transfer ownership to Customer.
- Quack Pack retains its lawful rights to recover its Equipment.
The Permanently Unreturned Equipment Charge is intentionally lower than the standard missing/destroyed Equipment replacement charge in recognition of holdover charges that may already have accrued.
If Equipment classified as permanently unreturned is later recovered, Quack Pack will not seek unreasonable duplicate recovery for the same loss and may adjust charges when reasonably appropriate based upon the condition of the Equipment, recovery costs and amounts previously paid.
6. QUACK PACK FEE SCHEDULE
The following Fee Schedule applies to this Agreement and reservation.
Missing or Destroyed Equipment
- Missing/Destroyed Bin Body: $12 each
- Missing/Destroyed Lid: $8 each
- Missing/Destroyed Complete Bin and Lid: $20 each
- Missing/Destroyed Dolly: $30 each
Normal wear resulting from ordinary intended use is not considered damage.
Failed Delivery / Pickup Trip
- Failed Trip / Re-Delivery / Re-Pickup Fee: $30 per occurrence
This fee applies when Quack Pack makes the scheduled delivery or pickup trip but cannot reasonably complete the service because of circumstances within Customer's control, including Equipment not being ready, Equipment containing Customer property, inaccessible premises, locked gates or buildings, incorrect addresses, failure to provide required access information, or similar circumstances.
A customer-requested reschedule made before Quack Pack makes the scheduled trip does not by itself trigger this fee.
Unapproved Rental Holdover
3% of the Package Rental Subtotal per calendar day
Maximum accrual period: 30 consecutive days
After the 30-day period, Quack Pack may classify remaining Equipment as Permanently Unreturned Equipment as described above.
Permanently Unreturned Equipment Charge After 30 Days
Bin Body: $6 each
Lid: $4 each
Complete Bin and Lid: $10 each
Dolly: $15 each
These charges are in addition to holdover charges already accrued before Equipment is classified as permanently unreturned.
Daily holdover charges stop when Quack Pack makes that classification.
Excessive Cleaning
Excessive Cleaning Fee: $30 flat per order
Ordinary routine cleaning between rentals is included and does not result in a cleaning fee.
The Excessive Cleaning Fee applies only when Equipment is returned in a condition requiring materially greater cleaning or remediation than ordinary rental use.
If an individual item cannot reasonably or safely be restored to rental condition and is instead treated as destroyed, Quack Pack will not also assess an excessive-cleaning charge for that same item merely to duplicate recovery.
Hazardous or Biological Contamination
Equipment contaminated by hazardous substances, biological material, chemicals, petroleum products, infestation or other materials that make normal cleaning unsafe or impractical may be treated as destroyed.
Customer is responsible for the applicable Equipment replacement charge and any reasonable actual third-party disposal or remediation costs incurred by Quack Pack.
Unauthorized Equipment Relocation / Recovery
Customer may not relocate Quack Pack Equipment to a materially different pickup location without Quack Pack's approval.
If Customer's unauthorized relocation of Equipment causes Quack Pack to incur additional travel, shipping, third-party retrieval or other recovery costs beyond the originally agreed pickup service, Customer is responsible for the reasonable actual additional recovery costs caused by that relocation.
Quack Pack will itemize such costs when assessed.
No Duplicate Recovery
Fees may be combined when they arise from separate events or separate losses. Quack Pack will not intentionally impose duplicative charges for the same specific damage or loss.
7. AUTHORIZATION TO SAVE AND CHARGE PAYMENT METHOD
PLEASE READ THIS SECTION CAREFULLY. CUSTOMER EXPRESSLY AUTHORIZES QUACK PACK LLC AND ITS PAYMENT PROCESSOR TO SAVE THE PAYMENT METHOD USED FOR THIS RESERVATION AND TO USE THAT PAYMENT METHOD FOR ONE OR MORE FUTURE CHARGES THAT BECOME DUE UNDER THIS RESERVATION AND AGREEMENT.
In addition to the original reservation payment, authorized charges may include:
- Approved additional products or services requested by Customer;
- Unapproved Rental Holdover Charges;
- Missing, lost, stolen or permanently unreturned Equipment;
- Damaged or destroyed Equipment;
- Missing lids or accessories;
- Missing or damaged dollies;
- Excessive cleaning;
- Hazardous contamination or actual disposal costs;
- Failed delivery or pickup trips;
- Additional recovery costs caused by unauthorized Equipment relocation;
- Applicable taxes; and
- Other amounts Customer separately authorizes in connection with this reservation.
The amount of any additional charge will be determined using the prices, rates or formulas contained in this Agreement, the Fee Schedule, the Order Summary, or another amount expressly approved by Customer.
Extension charges may accrue daily but may be processed periodically or as one accumulated charge.
Damage, loss, cleaning and similar charges generally will be assessed after inspection or after Quack Pack reasonably determines that the applicable charge has become due.
Quack Pack will provide an itemized electronic notice or receipt identifying post-reservation charges.
Customer authorizes Quack Pack to initiate these payments even when Customer is not actively using Quack Pack's website or participating in the payment transaction at that moment.
This authorization applies only to amounts arising from the applicable reservation or Customer's possession and use of the Equipment.
This authorization does not permit Quack Pack to charge Customer for unrelated products or services.
Quack Pack does not store Customer's complete card number or security code. Payment-card credentials are handled by Quack Pack's third-party payment processor.
If a saved payment method expires, is replaced, fails or cannot be charged, Customer remains responsible for all amounts validly due under this Agreement.
Nothing in this Agreement waives rights that applicable payment-card, banking, South Carolina or federal law does not permit Customer to waive.
8. CUSTOMER RESPONSIBILITY FOR EQUIPMENT
Customer assumes responsibility for the care, custody and reasonable protection of the Equipment from the time it is delivered or otherwise placed in Customer's possession until it is recovered by Quack Pack.
Customer must take reasonable measures to protect Equipment from theft, disappearance, intentional damage, fire, excessive heat, hazardous substances, unauthorized modification and unreasonable abuse.
Customer must not:
- Use Equipment for illegal purposes;
- Intentionally damage, cut, drill, paint or permanently mark Equipment;
- Expose Equipment to fire, extreme heat, corrosive substances or hazardous materials;
- Overload Equipment beyond its intended or manufacturer-rated use;
- Use bins as ladders, steps, chairs, flotation devices or passenger-carrying devices;
- Place children or animals inside Equipment;
- Alter or remove Quack Pack identification or inventory markings without permission; or
- Use Equipment in a manner inconsistent with its ordinary intended purpose.
9. LOST, STOLEN, MISSING OR DAMAGED EQUIPMENT
Customer is financially responsible for Equipment that is lost, stolen, destroyed, not returned or damaged beyond ordinary wear while in Customer's possession or control, except to the extent a loss is directly caused by Quack Pack after Quack Pack has retaken possession.
Normal scratches, scuffs and ordinary wear associated with proper use are not considered chargeable damage.
Examples of chargeable damage may include:
- Cracked or broken Equipment caused by misuse;
- Missing lids;
- Melted or burned Equipment;
- Permanent paint or markings;
- Structural damage;
- Chemical or biological contamination;
- Excessive adhesive or residue;
- Unauthorized modification; or
- Equipment that cannot reasonably or safely be returned to rental service.
Quack Pack may photograph, video, scan or otherwise document Equipment before delivery, during recovery and after return for inventory, condition, billing and claim purposes.
Customer is not responsible for properly documented pre-existing damage.
10. CLEANING
Ordinary cleaning associated with ordinary use is included in the rental.
Customer may be assessed the Excessive Cleaning Fee described in the Fee Schedule when Equipment is returned with conditions substantially beyond normal use, including excessive adhesive residue, paint, grease, chemicals, biological contamination, strong persistent odors, infestation or similar conditions requiring extraordinary cleaning.
Equipment that cannot reasonably or safely be restored to rental condition may instead be treated as destroyed.
11. DELIVERY, PICKUP AND PROPERTY ACCESS
Customer represents that Customer owns, occupies, manages or otherwise has lawful authority to permit Quack Pack to enter the scheduled delivery and pickup location.
Customer is responsible for obtaining any necessary permission from landlords, property managers, homeowners associations, condominium associations or other property owners.
Customer must provide reasonable and safe access to the Equipment and must disclose known material access limitations or hazards.
Customer is responsible for providing necessary:
- Gate codes;
- Building access;
- Elevator information;
- Parking instructions;
- HOA or property restrictions; and
- Other information reasonably necessary to complete delivery or pickup.
Customer agrees to secure pets and maintain reasonably safe access while Quack Pack personnel are present.
Quack Pack may decline, postpone or discontinue a delivery or pickup when conditions are reasonably believed to be unsafe.
12. CUSTOMER CONTENTS
QUACK PACK RENTS EQUIPMENT. QUACK PACK DOES NOT INSURE CUSTOMER'S BELONGINGS.
Unless Quack Pack separately agrees in writing to provide another service, Quack Pack is not acting as Customer's moving company, warehouse, storage facility, insurer or custodian of Customer's personal property.
Customer is solely responsible for determining what property to place in the Equipment and for packing, loading, transporting, storing, securing and protecting Customer's belongings.
All Equipment must be empty before Quack Pack retrieves it.
Quack Pack is not responsible for loss of or damage to Customer's belongings caused by Customer's packing methods, shifting, crushing, breakage, theft, movers, contractors, third parties, pests, storage conditions, temperature, humidity, weather, water or other conditions outside Quack Pack's possession and control, except to the extent liability cannot lawfully be limited.
Customer should not place illegal substances, explosives, flammable materials, biological waste, leaking liquids, corrosive chemicals or other dangerous materials in the Equipment.
13. STORM, WATER AND MOISTURE DISCLAIMER
QUACK PACK EQUIPMENT IS NOT REPRESENTED OR WARRANTED TO BE WATERPROOF, FLOODPROOF, WATERTIGHT, HURRICANE-PROOF OR CAPABLE OF PROTECTING PROPERTY FROM FLOODING, STORM SURGE, WIND-DRIVEN RAIN, RISING WATER, PLUMBING FAILURES OR OTHER WATER INTRUSION.
Plastic bins may offer organizational and moisture-resistance advantages compared with cardboard, but they are not substitutes for appropriate elevation, building protection, climate-controlled storage or insurance.
Customer is solely responsible for choosing where Equipment is stored and for determining whether the environment is appropriate for Customer's belongings.
Quack Pack does not guarantee that Equipment will prevent mold, mildew, condensation, humidity damage or water damage.
14. INSPECTION AND ACCEPTANCE OF EQUIPMENT
Customer should reasonably inspect Equipment upon delivery.
Visible shortages, significant defects or pre-existing damage should be reported to Quack Pack as soon as reasonably practical and preferably before the affected Equipment is used.
Quack Pack may replace defective Equipment when reasonably available.
Customer is not responsible for damage that Quack Pack determines existed before delivery.
15. DISCLAIMER OF WARRANTIES
TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, AND EXCEPT FOR EXPRESS PROMISES CONTAINED IN THIS AGREEMENT, THE EQUIPMENT IS RENTED "AS IS."
QUACK PACK DISCLAIMS, TO THE EXTENT LAWFULLY PERMITTED, IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE.
QUACK PACK DOES NOT WARRANT THAT THE EQUIPMENT IS SUITABLE FOR ANY PARTICULAR SPECIAL PURPOSE, INCLUDING FLOOD PROTECTION, LONG-TERM CLIMATE-CONTROLLED STORAGE OR PROTECTION OF PARTICULARLY VALUABLE OR SENSITIVE PROPERTY.
Nothing in this Agreement excludes a warranty, right or remedy that applicable law does not permit Quack Pack to exclude.
16. ASSUMPTION OF RISK
Customer acknowledges that packing, lifting, carrying, stacking, loading, unloading, moving and storing personal property involve inherent risks.
Such risks may include falling objects, lifting injuries, trip hazards, pinched fingers, shifting contents, improperly stacked Equipment, overloading and property damage.
Customer assumes risks arising from Customer's own use, misuse, packing, loading, transportation, storage and handling of the Equipment and from the acts or omissions of Customer's household members, guests, employees, movers, contractors and other third parties.
17. RELEASE AND LIMITATION OF LIABILITY
PLEASE READ THIS SECTION CAREFULLY. IT AFFECTS LEGAL RIGHTS.
To the fullest extent permitted by South Carolina law, Customer releases and agrees not to hold Quack Pack LLC, its members, owners, officers, employees, contractors and agents liable for claims, losses or damages arising from Customer's possession, packing, loading, transportation, storage or misuse of the Equipment, including reasonably foreseeable risks associated with those activities.
TO THE FULLEST EXTENT PERMITTED BY LAW, THIS RELEASE INCLUDES CLAIMS ATTRIBUTABLE TO QUACK PACK'S ORDINARY NEGLIGENCE TO THE EXTENT SUCH CLAIMS ARISE FROM THE RISKS AND ACTIVITIES EXPRESSLY DESCRIBED IN THIS AGREEMENT.
This release does not apply to liability that applicable law prohibits Quack Pack from waiving, including liability to the extent finally determined to result from Quack Pack's gross negligence, recklessness, intentional misconduct or fraud.
To the extent a complete release is not enforceable, Quack Pack's liability for covered property or economic loss arising from a reservation shall, to the fullest extent permitted by law, be limited to direct damages and shall not exceed the total amount Customer paid Quack Pack for the reservation giving rise to the claim.
To the fullest extent permitted by law, Quack Pack will not be liable for indirect, special, incidental or consequential economic damages, lost profits, lost opportunity or loss of use.
Nothing in this section limits liability for personal injury or another category of damages to the extent applicable law prohibits such limitation.
18. THIRD-PARTY MOVERS AND SERVICE PROVIDERS
Movers, storage facilities, contractors, property managers, Realtors, organizers or other third parties that recommend Quack Pack, receive referrals from Quack Pack or otherwise interact with Customer are independent businesses unless Quack Pack expressly states otherwise in writing.
Quack Pack is not responsible for the acts or omissions of independent moving companies, contractors, storage facilities or other third parties selected or hired by Customer.
A referral or recommendation does not by itself create a partnership, joint venture, employment, agency or other legal relationship between Quack Pack and the third party.
19. CUSTOMER INDEMNIFICATION
To the extent permitted by law, Customer agrees to defend, indemnify and hold harmless Quack Pack LLC and its members, owners, employees, contractors and agents from third-party claims, damages, costs and reasonable expenses arising from:
- Customer's misuse of the Equipment;
- Customer's violation of this Agreement;
- Customer's illegal, dangerous or hazardous contents;
- Customer's failure to obtain authorization for delivery or pickup access;
- Customer's packing, loading, transportation or storage activities; or
- Acts or omissions of Customer's household members, guests, employees, movers, contractors or others under Customer's direction or control.
This obligation does not require Customer to indemnify Quack Pack for liability to the extent indemnification is prohibited by applicable law.
20. CANCELLATIONS, MODIFICATIONS AND REFUNDS
Any reservation-specific cancellation, modification or refund terms disclosed during checkout or in the Order Summary are incorporated into this Agreement.
Quack Pack will not impose an undisclosed cancellation fee.
Once Equipment has been delivered or the rental period has begun, rental charges are generally non-refundable except where required by law or where Quack Pack materially fails to provide the agreed Equipment or service.
Quack Pack may cancel, postpone or modify delivery or pickup when reasonably necessary because of unsafe conditions, severe weather, governmental orders, Equipment unavailability, vehicle failure or circumstances beyond Quack Pack's reasonable control.
When Quack Pack permanently cannot fulfill a paid reservation, Quack Pack will provide the refund, credit or other remedy required by applicable law.
21. WEATHER AND EVENTS BEYOND QUACK PACK'S CONTROL
Quack Pack is not liable for delay or failure to perform caused by hurricanes, tropical storms, flooding, severe weather, road closures, governmental orders, natural disasters, utility failures, accidents, labor disruptions or other circumstances beyond Quack Pack's reasonable control.
Quack Pack may modify delivery or pickup schedules when reasonably necessary for the safety of customers, personnel or property.
Nothing in this section permits Quack Pack to retain payment for a service it permanently fails to provide when applicable law requires a refund.
22. COLLECTION OF UNPAID AMOUNTS AND RECOVERY OF EQUIPMENT
Amounts validly due under this Agreement remain Customer's responsibility regardless of whether the payment method used for the reservation can successfully be charged.
Quack Pack may use lawful means to collect unpaid amounts and recover its Equipment.
Customer agrees to cooperate in returning or making Quack Pack Equipment available following expiration or termination of the rental.
Customer is responsible for reasonable recovery, collection and legal expenses caused by Customer's material breach to the extent permitted by applicable law.
Quack Pack retains all lawful rights and remedies available under this Agreement and applicable law.
23. ELECTRONIC COMMUNICATIONS
Customer agrees that Quack Pack may provide reservation confirmations, copies of this Agreement, invoices, receipts, pickup reminders, delivery notices, extension notices, damage notices and other transaction-related communications electronically using the email address or telephone number provided by Customer.
Transactional communications are separate from promotional or marketing communications for which separate consent may be required.
Customer is responsible for maintaining accurate contact information.
Customer may request a retainable electronic or paper copy of this Agreement.
24. ELECTRONIC ACCEPTANCE AND SIGNATURE
Customer agrees to conduct this transaction electronically.
Customer's affirmative electronic acceptance, required checkbox selections, typed initials and submission of the reservation constitute an electronic signature and demonstrate Customer's intent to enter into this Agreement.
Quack Pack may retain an electronic acceptance record associated with the reservation, including:
- Customer's name;
- Customer's email address;
- Customer's typed initials;
- Reservation/order number;
- Agreement version;
- Fee Schedule version;
- Date and time of acceptance;
- Confirmation that the Rental Agreement was accepted;
- Confirmation that the payment-method authorization was accepted;
- IP address, when reasonably available;
- Browser or device user-agent information, when reasonably available;
- A copy or immutable record of the Agreement accepted; and
- A digital hash or similar integrity record of the accepted Agreement.
Customer agrees that such transaction metadata may be maintained for security, recordkeeping, audit and evidentiary purposes.
The authoritative acceptance timestamp may be generated by Quack Pack's server or database rather than Customer's device.
Quack Pack will maintain the accepted Agreement version in a form capable of later reference.
Future amendments to Quack Pack's terms do not retroactively alter the Agreement version accepted for an earlier reservation unless Customer expressly agrees otherwise.
25. GOVERNING LAW AND VENUE
This Agreement is governed by the laws of the State of South Carolina, except where controlling federal law applies.
To the extent legally permitted, any judicial proceeding arising from this Agreement shall be brought in a court of competent jurisdiction serving Horry County, South Carolina, unless applicable law requires another venue.
26. ENTIRE AGREEMENT; CHANGES; SEVERABILITY
This Agreement, the Order Summary, the Fee Schedule and any policies specifically incorporated during checkout constitute the agreement between Quack Pack and Customer regarding the rental.
The Fee Schedule applicable when Customer electronically accepts this Agreement governs that reservation and will not be retroactively replaced by a later fee schedule.
If Quack Pack and Customer subsequently agree to an extension, additional Equipment, additional service or other modification, that modification may be documented electronically and becomes part of the parties' agreement.
If any provision of this Agreement is determined to be invalid or unenforceable, the provision will be enforced to the maximum lawful extent or severed, and the remaining provisions will continue in effect.
Quack Pack's failure to enforce a provision on one occasion does not waive its right to enforce that provision later.
27. CUSTOMER REPRESENTATIONS AND FINAL ACKNOWLEDGMENT
By accepting this Agreement, Customer represents and acknowledges that:
- Customer is at least eighteen (18) years old and legally capable of entering into this Agreement;
- If acting for a company or other entity, Customer has authority to bind that entity;
- Customer has reviewed the rental dates, pricing and Equipment quantity;
- Customer understands that the Equipment remains Quack Pack property;
- Customer understands that additional charges may result from unapproved extensions, failed trips, loss, damage, missing Equipment, excessive cleaning, contamination and unauthorized relocation;
- Customer understands the 3% per-day Unapproved Rental Holdover Charge may accrue for up to 30 days;
- Customer understands that after 30 days Quack Pack may classify remaining Equipment as Permanently Unreturned and assess the applicable one-time charges;
- Customer expressly authorizes the payment method used for the reservation to be saved and used for amounts that become due under this Agreement;
- Customer understands that Quack Pack bins are not waterproof or floodproof;
- Customer has read and agrees to the Release and Limitation of Liability;
- Customer agrees to conduct the transaction electronically; and
- Customer intends the required checkbox selections and typed initials to constitute Customer's electronic signature.
ELECTRONIC ACCEPTANCE RECORD
Customer Name: ______________________________
Customer Initials: ___________________________
Reservation / Order Number: __________________
Agreement Version: QP-RA-2026-08-v1
Rental Agreement Accepted: YES / NO
Payment Authorization Accepted: YES / NO
Date / Time Accepted: ________________________
Electronic Acceptance Record ID: ______________