1st ADVANTAGE BAIL BONDS, LIC#74485
2429 TELEPHONE ROAD
HOUSTON, TEXAS 77023
PHONE: 713-847-9902/FAX: 713-847-9393
CREDIT CARD AUTHORIZATION FORM
TOTAL AMOUNT BEING CHARGED: ___________
Credit Card : Visa OR MasterCard <— circle one
Credit Card Number: ________________________________________
*Non Refundable Premium on Executed Bond *Non Refundable Travel Fees
*$75.00 Administrative Fee for every bond returned Unexecuted *INS Not Excluded
I the undersigned authorize 1st Advantage Bail Bonds to charge my credit card listed above for services rendered. I certify that I am authorized to incur charges on this credit card and that all information given on this form is true and correct. I understand that there will be no refund of any fees for Bond(s) or Administrative Fees. In the event that the defendant does forfeit his bail bond, it is expressly agreed and provided that upon default in the punctual payment of this note when it becomes due and payable we have the authorization to charge courts costs, administrative fees, and recovery fees to this credit account.
Billing address for this credit card
Billing City, State and Zip Code for this credit card
MUST RETURN/FAX ATTACHED WITH:
-YOUR DRIVER’S LICENSE / I.D.
-FRONT AND BACK OF CREDIT CARD