Copy this page with your Driver's License and Credit as indicated below.  Fill out the form, sign it and either mail it to The Law Offices of George A. Boyle, 416 Truxtun Ave., Bakersfield, CA 93301 or fax it to (661)327-4362.
 
 

FROM:     _______________________________________________
 

TO:       The Law Offices of George A. Boyle
 

Please bill $________________ to my credit card as indicated below.  The card number is

____________________________________  the card expires _______/______.   The billing for the card comes to

(full address including zip)______________________________________________________________________________

The amount billed is to be used exclusively for (name of client) _________________________________________

If you have any difficulties with this transaction, you can telephone me at (______)_________________ or (______)_________________
 
 

Put your Driver's License or ID Card here
Put your credit card here

I hereby authorize The Law Offices of George A. Boyle to bill by credit card as indicated above.
 
 

                                                            Signature  ___________________________________