Payment Form                                                                               Date of Receipt (for office use).  

(Revised 06/23)                                                                             

 Please select requested processing:  

   Expedited Handling – Fee is $25 per corporate document/$10 for copies/$15 for UCC 
   (NOT available for Apostille or Authentication Services, Service of Process, Notary Applications, Trademark Applications, or 
   Regulated Occupation Applications) 
   Regular Handling 

 This payment is for: 
  Authentication/Apostille Service                       Notary Application                Trademark Application 
  Copies                                                Regulated Occupation Application   UCC  
  Corporate Document                                    Service of Process                 Other _____________________ 
                                                                    
SUBMITTER INFORMATION: 
Complete all information for the person/company submitting the document to the Office. Corporate documents only: submitter will  
receive a file stamped copy of the filed document if it is submitted in duplicate.  
 
Submitter Name:             
Street:           
City/State/Zip:            
Phone:                             Fax:         
Email Address (required 
for expedited handling):                
 
DOCUMENT FILING INFORMATION: 
Complete all information regarding the document that is being submitted to the Office. 
 
Entity or applicant name 
listed on document:                     
Entity File # (if 
applicable):                            
Type of Document:                       
Number of Pages:            
 
PAYMENT INFORMATION:  
Check the box with your method of payment. Include the necessary information. 
  Check/Money Order Enclosed       Check/Money Order Number:                  
  Client Account: For instructions on how to create or fund a client account, visit https://www.sos.state.tx.us/modernization.shtml    
   Account #:             
   Name on Account:                
 
  LegalEase 
   Account #:     500679 -                            - -
   Client Reference #:             
     
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