Third Party Credit Card Authorization

File #(Required)

Name(Required)

First Last

Phone

Email(Required)

Billing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card Number(Required)

Expiration Date(Required)

MMYY

CVV(Required)

3 digits on the back for Visa/Mastercard or 4 digits on the front for AMEX

I hereby authorize Sodagar & Company Law Corporation to charge the balance due each month. Payment will be processed on the first day of each month for prior month fees.

Signature

Consent(Required)

I understand and agree that

I am paying for legal fees on behalf of a client with this firm. I further understand I will receive no direct benefit from this transaction or the legal services provided. I also understand I am waiving my right to dispute this charge with my bank for claims of services not received by cardholder or other similar claim of non-service.