Free Credit Card Cover Sheet - Oregon

SECRETARY OF STATE - CORPORATION DIVISION
255 Capitol Street, NE Suite 151 Salem, Oregon 97310-1327 Notary Public - Facsimile: 503-986-2300

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Credit Card Cover Sheet
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Notary Public
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. Notary Applicant Name: 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.
705 (Rev. 8/08)