Monthly Credit Card

Account #

Expiration Date

(CID) 3 Digit Number on Back of Card

Monthly Payment Amount

For the purpose of posting bail bond(s) for the following defendant(s)

Cardholder Name

Date

Billing Address

Telephone #

City

Zip

I hereby authorize Bill Davidson Bail Bonds to charge my Discover, Master Card, Visa or American Express every month until bond is paid in full. Furthermore, I agree to pay the above total amount according to the card issuer agreement. I hereby authorize Bill Davidson Bail Bonds to charge my Discover, Master Card, Visa or American Express every month until bond is paid in full. Furthermore, I agree to pay the above total amount according to the card issuer agreement. Yes

Number