Texas Sos Credit Card Payment Form
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1PAYMENT FORM
SECRETARY OF STATE
FAX: 512-463-5709
CORPORATIONS SECTION
FOR CUSTOMER USE ONLY
(PLEASE PRINT OR TYPE)
Cardholder Name:
Address:
City :
State:
Zip:
Phone No.: (
)
Fax No.: (
)
TYPE DOCUMENT TO BE FILED:
ENTITY NAME(s):
SHIP TO ADDRESS: (if different than Address above)
EXPEDITED HANDLING REQUESTED:
YES
NO
(Additional charge of $25 per document for expedited service)
SELECT PAYMENT TYPE AND PROVIDE REQUESTED INFORMATION
Charge to: Secretary of State Client ID No.:
(if applicable)
®
®
®
Charge to:
VISA
MasterCard
Discover
Charge to:
LegalEase
SM
* Fees paid by credit card are subject to a convenience fee
* For information about LegalEase
, call 1-800-253-5749
SM
(currently 2.7%) of the total fees incurred.
Card No.:
-
-
-
Card No.: 5 0 0 6 7 9 -
-
-
Expiration Date:
/
(MO/YR)
Client No.:
Case No.:
Signature:
Signature:
Client Reference:
(if applicable) (Not Secretary of State Client ID No.)
FOR SECRETARY OF STATE USE ONLY
AMOUNT
BATCH
NUMBER:
FILING FEE
EXPEDITED HANDLING FEE
Print
Reset
$
TOTAL AMOUNT
Form No. 807
(Rev. 09/06)
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