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I hereby authorize Texas Legal to charge the credit card below for an annual or monthly payment of my premiums, depending on my selection. This authority is to remain in effect until Texas Legal receives written notification from you revoking the authorization, subject to the terms and restrictions provided in the Certificate of Coverage. This credit card will be charged at the beginning of each month or year, as applicable. Payment is due on the 1st of the month. Your account may not reflect the charge until the 2nd or later, depending on the credit card vendor processing guidelines. I certify that I am the authorized holder and signer or have the consent of the authorized holder and signer of the credit card referenced below and that all information below is complete and accurate. I understand that this information will be securely maintained.