"Payment Form" - Texas

Payment Form is a legal document that was released by the Texas Secretary of State - a government authority operating within Texas.

Form Details:

  • Released on June 1, 2016;
  • The latest edition currently provided by the Texas Secretary of State;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Texas Secretary of State.

ADVERTISEMENT
ADVERTISEMENT

Download "Payment Form" - Texas

418 times
Rate (4.3 / 5) 25 votes
Payment Form
Date of Receipt (for office use).
(Revised 06/16)
Please select requested processing:
Expedited Handling (not available for Authentication Services or Trademark Applications)
($25 per corporate document/$10 for copies/ $15 for UCC)
Regular Handling
INSTRUCTIONS:
SUBMITTER INFORMATION:
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.
Document Filing Information: Completely fill out
City/State/Zip:
information regarding the document that is being
Phone:
Fax:
submitted.
Payment Information: Check the box with your method
Email:
of payment. Include the necessary information. For
Mastercard, Visa, and Discover, the Security Code is
DOCUMENT FILING INFORMATION:
the last three digits in the signature area on the back of
your card. For American Express, it is the four digits on
the front of the card. Fees paid by credit card are
Name listed on document:
subject to a statutorily authorized convenience fee of
File # (if applicable):
2.7% of the total fees incurred.
Type of Document:
Return To: Include a return address to which the
documents should be returned. If same as submitter,
Number of Pages:
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:
LegalEase
Zip Code:
-
Account #:
500679 -
-
Client Reference #:
Signature:
RETURN TO:
Same as submitter
Name:
Street:
City/State/Zip:
Phone:
Fax:
Email:
Print
Reset
Payment Form
Date of Receipt (for office use).
(Revised 06/16)
Please select requested processing:
Expedited Handling (not available for Authentication Services or Trademark Applications)
($25 per corporate document/$10 for copies/ $15 for UCC)
Regular Handling
INSTRUCTIONS:
SUBMITTER INFORMATION:
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.
Document Filing Information: Completely fill out
City/State/Zip:
information regarding the document that is being
Phone:
Fax:
submitted.
Payment Information: Check the box with your method
Email:
of payment. Include the necessary information. For
Mastercard, Visa, and Discover, the Security Code is
DOCUMENT FILING INFORMATION:
the last three digits in the signature area on the back of
your card. For American Express, it is the four digits on
the front of the card. Fees paid by credit card are
Name listed on document:
subject to a statutorily authorized convenience fee of
File # (if applicable):
2.7% of the total fees incurred.
Type of Document:
Return To: Include a return address to which the
documents should be returned. If same as submitter,
Number of Pages:
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:
LegalEase
Zip Code:
-
Account #:
500679 -
-
Client Reference #:
Signature:
RETURN TO:
Same as submitter
Name:
Street:
City/State/Zip:
Phone:
Fax:
Email:
Print
Reset