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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.

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

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Timestamp

Audit

January 18, 2020 3:09 pm PDT

Credit Card Update/Change Uploaded by Bob Richards - [email protected] IP 98.234.80.192, 172.68.189.254

November 11, 2020 3:20 pm PDT

bob richards - [email protected] added by Bob Richards - [email protected] as a CC'd Recipient Ip: 108.62.141.218, 108.162.219.129

November 11, 2020 3:20 pm PDT

bob richards - [email protected] added by Bob Richards - [email protected] as a CC'd Recipient Ip: 108.62.141.218, 162.158.62.122

November 11, 2020 3:31 pm PDT

bob richards - [email protected] added by Bob Richards - [email protected] as a CC'd Recipient Ip: 98.234.80.192, 172.68.142.216