Form Sfn 13003 - North Dakota Nonprofit Corporation Articles Of Incorporation Page 3

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SFN 13003 (07-2008) Page 3
CREDIT CARD PAYMENT AUTHORIZATION
SECRETARY OF STATE
SFN 51478 (11-06)
(All items required to complete transaction)
Name:
Amount Authorized
Address:
City:
State:
Zip Code:
Signature: (Required by credit card companies)
VISA
Master Card
Discover
Account Number:
V #
Card Expires:
Month
Year
Date:
-

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