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You are agreeing to pay $ plus a Fee of $ (%) for a Total of $.

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I authorize Southern Credit Adjusters INC to process the above payment of $. I also authorize Southern Credit Adjusters INC to store this information in compliance with payment processing regulations and to charge the card listed above for future payments in accordance with their terms. I understand that to make any changes to this authorization I must contact Southern Credit Adjusters INC prior to the payment date.

I authorize Southern Credit Adjusters INC to process the payments as outlined in the payment schedule. I also authorize Southern Credit Adjusters INC to store this information in compliance with payment processing regulations and to charge the card above for future payments in accordance with their terms. I understand that to make any changes to this authorization I must contact Southern Credit Adjusters INC prior to the payment date.

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