CREDIT CARD AUTHORIZATION FORM

I, ______________________________________, give authorization to Nevada Divorce and Paralegal Services, Inc. to charge $_____________ to the credit card designated below for typing services and/or court costs for ________________________.

I understand that Nevada Divorce and Paralegal Services, Inc. will process the charge immediately and that any cancellation of services at a later date will not be entitled to a refund of typing services, only pre-paid court costs that have not been expended.

I further declare that the signature appearing below is identical with the signature appearing on this credit card.

Credit Card Number ____________________________________

Name on Card _________________________________

Billing Address _________________________, ____________, ____, _______

Exp. Date ___________________ Billing Zip Code __________________

Date of Authorization: _____________________

Signature of Card Holder: ____________________________

Telephone Number: ______________________

Thank You.

NEVADA DIVORCE & PARALEGAL SERVICES

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