928-773-1997

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Hours of Operation: 7 days/week including Holidays

CREDIT CARD AUTHORIZATION

You must call us to obtain the bond amount and fees charged before submitting the Credit Card Authorization Form.

CREDIT CARD AUTHORIZATION FORM

CREDIT CARD AUTHORIZATION

"*" indicates required fields

INMATE INFORMATION

Inmate's Name*
(Must provide at least a Booking Number or Date of Birth)
Date of Birth
Booking No
(Must provide at least a Booking Number or Date of Birth)

CREDIT CARD INFORMATION

Cardholder's Name*
*Name must match the credit card & driver's license EXACTLY
Email*
Billing Address*
(Use 1234-1234-1234-1234 FORMAT)
(Please input your credit card expiration date in month/year format such as 02/14)
(3 or 4 digit Security code on front or back of Card)
(This dollar amount must come from us. Please enter the agreed upon charge amount)

PICTURES

Accepted file types: jpg, gif, png, pdf, Max. file size: 256 MB.
(You must upload a copy of your driver license held next to your face for security purposes.)
Max. file size: 256 MB.
(You must upload a legible copy of the front of your credit card. It must be a card with the name that matches the driver license.)
Max. file size: 256 MB.
(You must upload a legible copy of the back of your credit card. It must be a card with a signature that matches the one used on our form. Unsigned cards will not be accepted.)

(Please sign with mouse, stylus, or finger)
This field is for validation purposes and should be left unchanged.