Make A Payment Over The Phone

Over The Phone Credit Card Authorization

To authorize a credit card payment over the phone, please complete the authorization form below. Upon completing the authorization form, you must call the Clerk’s Office at (706) 665-3239 and notify the Clerk you have submitted the Online Authorization Form and would like to pay by credit card over the phone.

Credit Card Payment Authorization Form

Cardholder Information

Name(Required)

First Last

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Phone(Required)

Email(Required)

Payment Details

Case Number (if known):(Required)

Type of Payment(Required)

Filing Fee

Fine

Copy/Record Fee

Other

Amount Authorized:(Required)

Card Type(Required)

Visa

MasterCard

Discover

American Express

Name on Card:(Required)

Card Number(Required)

Expiration Date (MM/YY)(Required)

CVV:(Required)

AUTHORIZATION

I authorize Talbot County Superior Court to charge my card for the amount listed above. I understand that a convenience fee will apply to credit/debit card transactions and that this authorization is valid only for the payment specified. I also understand that declined transactions may delay processing.

Cardholder Signature(Required)

Date(Required)

Make A Payment Over The Phone

Over The Phone Credit Card Authorization

Credit Card Payment Authorization Form

Cardholder Information

Payment Details

AUTHORIZATION

Mailing

Office

Office Numbers

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