I, First Name* Last Name* , as the cardholder, hereby authorize Headley Legal Support Services, Inc. to Pre Authorize my Debit/Credit Card for ${notaryService} and confirm the information for this card is complete and accurate. I can cancel at any time before 6 hours of my appointment without penalty. Otherwise, I will be charged 50% of ${notaryService} if I am a "NO SHOW" or cancel my appointment.I agree to the terms & conditions Signature