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Card Payment Form. This is a Texas form and can be use in General Business Secretary Of State.
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Tags: Card Payment Form, 2101, Texas Secretary Of State, General Business
Payment Form
This space reserved for office use.
(Revised 05/11)
Expedited Handling Requested?
$25 per document
(not available for Apostilles and some other filings)
Yes
No
Payment Information
Type:
American Express
Discover
Client Account
LegalEase
Visa
-
Credit Card, Client ID, or LegalEase Number:
MasterCard
-
-
Credit Card Expiration Date (mm/yyyy):
Name as it Appears on Card or Account:
Billing Address
Street:
City:
State:
Signature:
Zip Code:
Date:
Fees are calculated based on the secretary of state fee schedule. Fees paid by credit card are subject to a
statutorily authorized convenience fee of 2.7% of the total fees incurred.
Contact Information for Recipient of Documents
(include shipping address here if different from billing address)
Name:
Street:
City:
Fax:
State:
(required for expedited filings)
Zip Code:
Phone:
Request or Filing
It is important that you identify each request or filing associated with this payment in case your payment form is
separated from your request or filing. If we cannot match your payment form with your request or filing, your
request or filing will be processed as if it was submitted without payment. If paying for more than three
transactions, attach an additional page identifying each additional transaction.
Transaction 1
Type of Filing/Request (e.g., “certificate of
formation”, “certified copies” or “Apostille”):
Name on Document (if applicable):
Secretary of State
File Number (if any):
Transaction 2
Type of Filing/Request (e.g., “certificate of
formation”, “certified copies” or “Apostille”):
Name on Document (if applicable):
Secretary of State
File Number (if any):
Transaction 3
Type of Filing/Request (e.g., “certificate of
formation”, “certified copies” or “Apostille”):
Name on Document (if applicable):
Secretary of State
File Number (if any):
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