Credit Card Change Addendum

I hereby authorize SeniorLeads to update the credit card on file for the billing of services rendered according to the terms of the service agreement, to the following:

Card Holder Name:  
Email address on Seniorleads account:  
Credit Card number:    
Expiration:  
3-digit Security Code on back of card:   
Billing Street Address:   
City:   
State:   
Zip:   

I acknowledge that the terms and conditions put forth in the initial Service Agreement remain the same and will apply to the updated credit card information, provided above.

Select one of the checkboxes below:

WE WILL USE THIS NEW CARD FOR ANY OUTSTANDING BALANCE AND FOR CHARGES GOING FORWARD. IF YOUR ACCOUNT HAD BEEN SUSPENDED, WE WILL REACTIVATE YOUR ACCOUNT UNLESS YOU CHECK BELOW TO CLOSE YOUR ACCOUNT

ALLOW ONE FULL BUSINESS DAY FOR THE CHANGE TO BECOME EFFECTIVE

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Your legal name

Your email address

Please Confirm full name and signature.

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• Type In Signature
  

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I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

Insert Signature

I agree that I am and I understand this is a legal representation of my signature

Adopt & Sign

Signature Certificate

Document name: credit card change

Unique Document ID: e87de920d6b885d13a44fae48fed81df0d734a66

Build. Track. Sign Contracts.

Timestamp	Audit
July 11, 2018 2:08 pm PDT	credit card change Uploaded by Jennifer Blair - [email protected] IP 98.234.80.192
July 11, 2018 3:20 pm PDT	Lisa Johnson - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 24.5.135.88, 24.5.135.88
July 11, 2018 3:24 pm PDT	Lisa Johnson - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 24.5.135.88, 24.5.135.88
July 12, 2018 10:33 am PDT	Lisa Johnson - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 24.5.135.88, 24.5.135.88
July 12, 2018 10:35 am PDT	Lisa Johnson - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 24.5.135.88, 24.5.135.88
July 12, 2018 10:43 am PDT	Lisa Johnson - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 24.5.135.88, 24.5.135.88
July 12, 2018 12:42 pm PDT	Lisa Johnson - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 24.5.135.88, 24.5.135.88
July 12, 2018 12:44 pm PDT	Lisa Johnson - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 24.5.135.88, 24.5.135.88
January 28, 2019 12:04 pm PDT	Lisa Johnson - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 24.5.135.88, 24.5.135.88
October 17, 2019 3:53 pm PDT	Lisa Johnson - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 10.73.196.1
October 17, 2019 3:54 pm PDT	Lisa Johnson - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 10.73.196.1
December 31, 2019 12:33 pm PDT	Lisa Johnson - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 10.73.196.1
May 13, 2020 11:38 am PDT	Lisa Johnson - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 24.5.135.88
September 2, 2021 1:41 pm PDT	Jennifer Blair - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 98.234.80.192
September 14, 2021 3:07 pm PDT	Jennifer Blair - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 98.234.80.192

This audit trail report provides a detailed record of the online activity and events recorded for this document.

https://seniorleads.com/

Audit Trail Serial# 9734f71af86248f74e396670ea222733