Montcalm County, MI · Montcalm County
Credit/Debit Card Authorization
Montcalm County Clerk's authorization form lets people paying for a vital record by mail or fax provide card and payment details.
At a glance
- Issued by
- City of Montcalm County · Montcalm County, Montcalm County, Michigan
- Notarization
- Not required: file this form without a notary.
- Official source
- montcalm.us
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Use this form when applying for a vital record by mail or fax and paying by Visa, MasterCard, or Discover credit or debit card. It requests the cardholder's name, billing address, card details, phone number, number and type of records ordered, and the total authorized amount. The form lists $30 for the first certified copy and $5 for each additional copy of the same record, plus a small service fee.
Who needs it
Anyone applying for a vital record by mail or fax and paying by credit or debit card should complete this authorization.
How to submit it
Fax the completed authorization with your vital record application to 989-831-7474. The form lists the Montcalm County Clerk's Office at 211 W. Main Street, PO Box 368, Stanton, Michigan 48888.
About notarization
This document is signed without a notary; the cardholder just signs and dates the authorization.
How to submit this form
- 1
Download the Form
Download the Credit/Debit Card Authorization form.
- 2
Complete the Authorization
Enter the cardholder, billing, card, phone, vital record, and payment information requested.
- 3
Gather the Application
Include the completed vital record application; the authorization is required with applications submitted by mail or fax.
- 4
Fax to the County Clerk
Fax the authorization with your application to 989-831-7474.
Frequently asked questions
- Who uses the Credit/Debit Card Authorization?
- People applying for a vital record by mail or fax who wish to pay by Visa, MasterCard, or Discover credit or debit card use this authorization.
- What information does the authorization request?
- It asks for cardholder and billing details, card number and security code, expiration date, phone number, record type and quantity, total authorized amount, signature, and date.
- Do I need a notary for the Credit/Debit Card Authorization?
- No. This document is signed without a notary; the cardholder just signs and dates the authorization.
- How do I submit the Credit/Debit Card Authorization?
- Fax the completed authorization with your vital record application to 989-831-7474, as directed on the form.