Expert Data Forensics Payment Authorization Form

Credit Card Information

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Sign and complete this form to authorize Expert Data Forensics, LLC to debit your card listed below. By signing this form you give us permission to debit your account the amount indicated on or after the indicated date.
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  • - select a state -
  • Alabama
  • Alaska
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • District of Columbia
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
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  • Payment Type
  • Visa
  • MasterCard
  • AMEX
  • Discover
  • Check
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Do you want us to email you a receipt communication regarding billing?
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Being that I am the cardholder and by signing below I understand and agree to the terms set forth in this agreement. I agree to pay, and specifically authorize Expert Data Forensics to charge my credit card for services as described above and/or by the Service Agreement, job scope or quote.
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