SECRETARY OF STATE - CORPORATION DIVISION
255 Capitol Street, NE Suite 151 Salem, Oregon 97310-1327 UCC - Facsimile: 503-373-1166
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Credit Card Cover Sheet
To:
Uniform Commercial Code
MasterCard or VISA
Method of payment: Credit Card Number:
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Expiration Month/year: Please provide the following information, in case there are questions concerning your filing. Cardholder Name: Billing Address: City, State, Zip Code: Phone Number: Business Name:
Other Notes or Comments:
The Corporation Division offers filing by fax for our programs. When filing by fax, a Visa or MasterCard must be used for payment.
704 (Rev. 8/08)