Please complete this form, print, and fax to RexEncore Media at +1 (618) 463-0733. You can also scan and email this form to or simply submit the information below.

By signing and completing this form, you authorize RexEncore Media, LLC to charge your credit card for your advertising as outlined in your signed Advertising Agreement and, if necessary, initiate adjustments for any transactions credited/debited in error.

This authority will remain in effect until RexEncore Media, LLC  is notified by you in writing to cancel it (with 2 weeks notice).
If you prefer to submit authorization manually, please print this.pdf and email to or fax 618-463-0733

Download "Authorization.pdf"