Texas Sos Payment Form 807 – Fill Out and Use This PDF

SUBMITTER INFORMATION:

INSTRUCTIONS:

Mark the appropriate handling request.

Company/Firm or

If expedited include an email address.

Individual Name:

Submitter Information: Completely fill out information

Street:

of the person/company submitting the documents.

City/State/Zip:

Document Filing Information: Completely fill out

information regarding the document that is being

Phone:

Fax:

submitted.

Email:

Payment Information: Check the box with your method

of payment. Include the necessary information. For

DOCUMENT FILING INFORMATION:

Mastercard, Visa, and Discover, the Security Code is

the last three digits in the signature area on the back of

your card. For American Express, it is the four digits on

Name listed on document:

the front of the card. Fees paid by credit card are

File # (if applicable):

subject to a statutorily authorized convenience fee of

2.7% of the total fees incurred.

Type of Document:

Return To: Include a return address to which the

Number of Pages:

documents should be returned. If same as submitter,

check the box.

PAYMENT INFORMATION:

Visa

Mastercard

-

Discover

American Express

Check/Money Order Enclosed (no electronic check)

Card #:

-

-

Exp (MM/YY):

Security Code:

Client Account

Name on Card:

Account #:

Billing Address:

Name on Account:

City/State:

Zip Code:

LegalEase

-

Account #: 500679 -

-

Signature:

Client Reference #:

RETURN TO:

Same as submitter

Name:

Street:

City/State/Zip:

Phone:

Fax:

Email: