Business And Public Filings Division Payment Form
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Business And Public Filings Division Payment Form. This is a Texas form and can be use in General Business Secretary Of State.
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Tags: Business And Public Filings Division Payment Form, 815, Texas Secretary Of State, General Business
REPORTS UNIT FILINGS
PHONE: 512-475-2705
FAX: 512-463-1423
(Professional Association Annual Statement,
Limited Partnership Periodic Report,
Nonprofit Corporation Periodic Report)
SECRETARY OF STATE
BUSINESS AND PUBLIC FILINGS DIVISION PAYMENT FORM
FOR CUSTOMER USE ONLY (PLEASE PRINT OR TYPE)
Cardholder Name:
Address:
City:
State:
Phone No.: (
)
Fax No.: (
Zip:
)
TYPE DOCUMENT TO BE FILED:
ENTITY NAME(s):
SHIP TO ADDRESS: (if different than Address above)
EXPEDITED HANDLING REQUESTED:
YES
NO
(Additional charge of $25 per document for expedited service)
SELECT PAYMENT TYPE AND PROVIDE REQUESTED INFORMATION
Charge to: Secretary of State Client ID No.: (if applicable)
Charge to:
American Express
Card No.:
Expiration Date:
-
Discover
/
MasterCard
VISA
Charge to:
LegalEaseSM
Card No.: 5 0 0 6 7 9 -
-
Client No.:
(MO/YR)
-
-
Case No.:
*For information about LegalEaseSM, call 1-800-253-5749
Signature:
Charge to: Client ID No.: (if applicable) (Not Secretary of State Client ID No.)
FOR SECRETARY OF STATE USE ONLY
DESCRIPTION
AMOUNT
BATCH
NUMBER:
FILING FEE
EXPEDITED HANDLING FEE
SUBTOTAL
$
CONVENIENCE FEE 2.7% (when applicable)
(American Express, Discover, MasterCard, or VISA only)
TOTAL AMOUNT
Form No. 815
$
(Rev. 05/11)
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