Alabama Corporation Credit Card Payment Slip Form

In the State of Alabama, submitting a form to the Secretary of State’s office entails the payment of a filing fee. When paying for any sort of filing fee, a completed version of this slip must be used by the corporation’s representative.

Extracted Text for Proper Search

STATE OF ALABAMA 
OFFICE OF THE SECRETARY OF STATE  
BUSINESS SERVICES DIVISION 
FAX (334) 240-3138 	
 
 
MAILING ADDRESS	
        
PHYSICAL ADDRESS	
PO Box 5616        RSA Union Bldg, Suite 770 
Montgomery, AL  36103-5616          100 North Union Street 
         Montgomery, AL  36130 
 
 
 
CREDIT CARD PAYMENT SLIP  
  (Visa, MasterCard, Discover, and American Express) 
Card Type:     
 
 
Card Number:        
 
Expiration Date (Mo/Yr  – 4 digits required):  / 	
 
 	
 
 
Card Holder Name:            
 
 
Billing Address:            
 
City/State/Zip:   
        	
,  	     	
 
 
 
 
Typed Name of Authorized Signature:         	
**Name should only differ from Card Holder  if this is a corporate/business card. ** 
 
   
Authorized Signature for Card Holder:         	
CC SLIP – 8/2010