Arizona DUI Defense.com - Law Office of David Alan Darby - 177 N. Church, Suite 909, Tucson, AZ. 85701

520-620-0000  *  520-620-0818 [fax]  *  888-620-0001 [toll free]  *  Site Map  *  Email Us!

Tucson DUI Lawyer Tucson DUI Attorney

Credit Card Form

If you are paying with a credit card please note the following information must be provided in order for us to accept your credit card payment:

  1. We need a legible copy of your driver license if you still have it.  If you do not have a driver license i.e. the police took it away from you during the DUI investigation, please provide a copy of some other form of ID.

  2. We need a legible copy of the credit card you are intending to use front and back. 

  3. We need the form below filled out completely, signed and faxed or emailed back to us.

  4. For your convenience the form below is available in the following formats:

MSWord Format, click here,    WordPerfect format, click here,   Simple Text format, click here

or

Print out this page, fill it out completely and fax it back to us at

1-520-620-0818

 

 LAW OFFICE OF

DAVID ALAN DARBY

P.O. Box 12427

Tucson, Arizona 85732

CREDIT CARD CHARGE AUTHORIZATION AGREEMENT

I, _______________________________, the holder of the following credit card (check one, please): 

VISA ___ MasterCard ___ Amex  ___ Discover ___ 

Card Number: ___________________________ Exp.Date ____/____ with a three digit security code ______ on the back of the card, hereby authorize The Law Office of David Alan Darby, in Tucson, Arizona to charge my credit card in the amount of:

$___________________________________________________ for attorney’s fees for legal representation for _________________.   

I further authorize the Law Office of David Alan Darby to charge my credit card each month beginning the ______ day of __________, 2003 in the amount of $____________ each month, for the period of ____ months for attorney’s fees for continued legal representation. 

Cardholder: ______________________________________________

Signature: _______________________________________________

Company: _______________________________________________

Billing Address: __________________________________________

                                     Where you receive you credit card statement

 

City, State, Zip: ___________________________________________

Telephone: (_______) ______________________________________

Date: __________________________________________________

Fax or email this completed form to Law Office of David Alan Darby

Direct Fax: (520) 620-0818    Email: david@arizona-dui-defense.com

 

 

[Home] [1-800-DIAL-DUI-Members] [2006 Arizona DUI Law Update - Arizona DUI Defense] [20 Frequently Asked Questions About Arizona DUI] [Driving-Arizonas-DUI-Law-Just-Got-Tougher] [About David Alan Darby, Esq. Arizona DUI] [Alcohol Effects Arizona DUI] [Arizona Drivers Rights Card, Arizona DUI Defense] [Arrested for DUI Outside the State of Arizona - Arizona DUI Defense] [Arizona DUI Arrest Process - Arizona DUI Defense] [Arizona DUI Checkpoints] [Arizona DUI Cop Tricks - Arizona DUI Defense] [Arizona DUI Defenses] [Arizona DUI Quicktips] [Arizona DUI Defense Resource Page] [Winning Your DUI!] [ARS13-3401 - DUI Information for Arizona] [BAC Calculator, Arizona DUI Defense] [Contact Us! Arizona DUI Defense] [Arizona Conviction for DUI Gets Your Name in the Paper] [DUI Case Info Sheet - Arizona DUI Defense] [darby-cc-authorization.doc] [darby-cc-authorization.wpd] [Driver License Agencies from the 50 States - ARIZONA DUI DEFENSE] [DRE Opinion - Arizona DUI Defense] [DUI Articles - Arizona DUI Defense] [DUI Exceptions to the Constitution] [FSTs Standards - Arizona DUI Defense] [HGN Article - Layne Means] [NHTSA Highway Safety Boo] [More Arizona DUI Info] [Miranda- What is it? Arizona DUI Defense] [Not From Arizona? - Arizona DUI DefensE] [Old Pima County Courthouse, Tucson, Arizona] [Out of State DUI Information - Arizona DUI Defense] [Arizona DUI - DUI REASONABLE SUSPICION] [Jury Trial Right Under Attack] [Site Map, Arizona DUI Defense, Law Office of David Alan Darby] [Stolen From OU Police Site] [Standardized Field Sobriety Test (SFST) Validation Studies] [Walk And Turn - Arizona DUI Defense] [Resource Page 2 - Arizona DUI Defense] [One Leg Stand - Arizona DUI Defense] [Arizona DUI Read Me First!] [DUI PROBABLE CAUSE - Arizona DUI] [Payment Plans, Arizona DUI Defense] [Intoxilyzer 5000 Information] [H.G.N. - Arizona DUI Defense] [Arizona DUI-Maricopa DUI Court Center] [Field Sobriety Testing- Article by Steve Rubenzer, Ph.D] [Links Redirect] [FST's - Field Sobriety Tests and Testing] [Beware Dumptrucks! Arizona DUI Defense] [DUI Defense Attorney Directory - ARIZONA DUI DEFENSE] [DUI Attorney List] [Disclaimer - Arizona DUI Defense] [Arizona DUI Law Q & As - Arizona DUI Defense] [darby-cc-authorization.ans] [Credit Card Form] [BAC Testing, Blood and Breath Tests] [Arizona DUI Penalties and Sentencing Chart - Arizona DUI Defense] [Driver License Warning!] [DUI in Arizona, MVD, And Your Driver License] [Arizona DUI Nutshell] [Arizona-DUI-Drugs] [Arizona DUI FAQ's] [Arizona DUI Fees Increase in 2005] [DUI in Arizona - Latest Developments] [Arizona DUI Laws] [Arizona DUI Law Changes] [Arizona DUI Lawyer] [Arizona DUI Attorney] [Arizona DUI Attorneys] [Arizona DUI Lawyers] [Arizona DUI Law] [Arizona DUI Laws] [Tucson DUI Attorney] [Tucson DUI Lawyer] [Tucson DUI Lawyers] [Tucson DUI Attorneys] [Tucson DUI Law] [Tucson DUI Laws]

Copyright ©  2006 Darby Law Office

 1-800-DIAL-DUI     Arizona Criminal Defense    Arizona DUI Attorney Arizona DUI Lawyer  Arizona DUI Attorneys  Arizona DUI Lawyers   Arizona DUI Law   Arizona DUI Laws  Tucson DUI Attorney

 Tucson DUI Lawyer   Tucson DUI Attorneys   Tucson DUI Lawyers  Tucson DUI Law   Tucson DUI Laws