Credit Card Update/Change Form

I hereby authorize advisor-newsletter.com to update the credit card on file for the billing of services rendered according to the terms of the service agreement, to the following:

Name on Newsletter Account:   
Card Holder Name:  
Credit Card number:  
Expiration:  
3-digit Security Code (back of card):  
Billing Street Address:  
City State Zip Code  

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.

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Your legal name

Your email address

Please Confirm full name and 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

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

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Signature Certificate

Document name: Newsletter Credit Card Change

Unique Document ID: 01088bd27459ed123856f9154ae83c32a8ce3b2c

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Timestamp	Audit
January 13, 2020 11:12 am PDT	Newsletter Credit Card Change Uploaded by Jennifer Blair - [email protected] IP 10.73.196.1
January 13, 2020 11:31 am PDT	bob richards - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 10.73.196.1
January 13, 2020 11:33 am PDT	bob richards - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 10.73.196.1
January 13, 2020 11:34 am PDT	bob richards - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 10.73.196.1
January 13, 2020 11:35 am PDT	bob richards - [email protected] added by Jennifer Blair - [email protected] as a CC'd Recipient Ip: 10.73.196.1

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

http://seniorleads.com/

Audit Trail Serial# 9734f71af86248f74e396670ea222733