I hereby authorize the charging(s) of my credit card as indicated.
By signing this credit card authorization form you are also granting us permission to charge your card and the use of your signature on file for any additional charges that may arise in the future pertaining to your obligation/s as an indemnitor for this $ license bond(s). The undersigned accepts and agrees to all of the bond terms and financial obligations as stated in the license bond indemnity agreement and acknowledges that they are a part of this credit card authorization form for future charges. I agree to indemnify and hold harmless the surety or its agent for all losses in connection with this bond(s) not otherwise prohibited by law. Facsimile copy is considered as if an original.
NOTE: Charges are subject to a processing fee of 3% that will be subtracted from any refund or returns owed, an additional $150.00 application/
posting processing fee may be applied for any cancellation. Premium is fully earned upon the issuing of the bond(s).
I HAVE READ AND AGREE TO ALL OF THE ABOVE.