| Davis Bail Bonds |
| 1755 Saint Mary Avenue Pensacola, Florida 32501 Phone: (850) 433-2811 Fax: (850) 433-5069 tdavis91@bellsouth.net |
| Credit Card Voucher |
| I, , certify that I am the card holder for |
| Visa, Master Card, Discover, AMEX (Please Circle One) |
| Card # Expiration Date / / |
| and I authorize Davis Bail Bonds to charge my card for services they have rendered regarding Power#(s) |
| posted on behalf of defendant,
in the amount of $
. |
| I have freely signed this identification voucher in the order to add additional security to this particular transaction which will aid in protecting both I, the card holder, and this merchant. |
| Please find attached copy of my state I.D./D.L. along with a copy of the card I have authorized to be charged for this requested transaction. |
| My card billing address on file is |
| Signature:__________________________________________________________ |
| Date:_________________________________ |