RAPT Therapeutics, Inc. Virtual Credit Card Payment Authorization Form

By completing and submitting this form, you:


  • Authorize RAPT Therapeutics, Inc. to make your future invoice payments using virtual credit cards emailed to the "Payments Email Address" below.
  • Confirm you are able to accept and process virtual credit card payments by email and will not charge additional service fees for credit card payments.
  • Acknowledge you have a merchant processor account for credit card payments.


You will begin receiving payments by virtual card as soon as RAPT Therapeutics, Inc. reviews and approves your payment change.

 
 

Enter the email address where your virtual credit cards should be sent

 

Person approving the payment method change for your company (typically someone in Finance or AR)