CREDIT CARD AUTHORIZATION

Each card you wish to liquidate will require an authoirzation. We've provided one form that will work for three cards.

If you need use more than three cards, after this form is submitted, you'll be allowed to fill out the form again for teh additional cards.

*3-Digit number found on the far right of the backside of VISA, MasterCard, and Discover cards 

4-Digit number found on the front right side of American Express card

If you would like the same card used in multiple transactions, you can add the amount of the transactions as follows: 1st - $4795, 2nd - $9565, 3rd - $9975, 4th - 7565, etc., on the same line

Credit Card Expiration Date:

Credit Card Billing Address

2nd Card

Credit Card Expiration Date:

Credit Card Billing Address

3rd Card

Credit Card Expiration Date:

Credit Card Billing Address

AUTHORIZATION: I have authorized Marker Law Mediation, Morrison Law Group, and/or Parly Law Group, to charge the above amount in US Dollars.  The goods and/or services are specifically described as payment to the trust account for the facilitation of an escrow transaction by me with another entity. The law offices are authorized to facilitate the transaction.