Internet Payments
Payment/Authorization Information:
Amount:
*
(ex. 2000.00 - No "$" or ",")
Description:
(ex. Bail Bond for Joe Defendant)
Billing Information:
First Name:
*
Last Name:
*
Address:
*
City:
*
State:
*
Zip Code
*
(5 digits)
Country:
Phone:
*
Fax:
Email:
Terms and Conditions:
The cardholder, having made application for (or renewal of) a surety, or bail bond(s), to be issued by The Bail Bond Doctor, a California insurance licensed bail agent, hereby authorizes The Bail Bond Doctor, its employees, agents or representatives to charge the bail bond premium/renewal entered into this online form. The authorization information below shall be held on file in strict confidence. The credit card may be checked for validity before issuance of the bail bond(s). The card number may be used to pay the premium when it becomes due until this authorization is cancelled in writing by the undersigned, provided, however, as long as the bail bond obligation undertaken by The Bail Bond Doctor is in force, this authorization will remain in full force and effect until such time as the bail bond obligation referred to herein is fully exonerated or discharged. The cardholder agrees that The Bail Bond Doctor may pursue all means possible to collect on obligations owed to The Bail Bond Doctor. The undersigned further agrees to authorize The Bail Bond Doctor to submit credit card charges using the credit card entered into this online form to recover all payments due and all other unpaid amounts for the payment of premiums, premium renewals or forfeitures. I hereby declare that I am the holder of the above credit card to use it to pay premium(s) or renewals for Bail Bonds provided by The Bail Bond Doctor. I also understand that this credit card may be charged for any future invoice for any and all costs associated with this/these bail bond(s).
I have read the Terms and Conditions and agree to them.
*
= Required Field
The Bail Bond Doctor
- Online Payment