Stephentown, NY · Rensselaer County
Credit Card Authorization Form
Stephentown Justice Court defendants use this form to authorize payment of a fine and service fee by credit card.
What this form is
Use this form to authorize Stephentown Justice Court to charge a fine and service fee to a credit card. The form requests the payer’s name, date of birth, case or ticket number, card details, phone number, signature, and date. Include a copy of the payer’s photo ID; the form says payment will not be processed without it.
Who needs it
People paying a Stephentown Justice Court fine by credit card can use this form to authorize the payment.
How to submit it
Submit the entire form to the court at 26 Grange Hall Road, Stephentown, NY 12168, or use the listed fax or email. The form says payment is not accepted by phone.
About notarization
This form is signed and dated without a notary; it asks for a copy of the payer’s photo ID, but does not require a notarized attachment.
How to submit this form
- 1
Download The Form
Download the Credit Card Authorization Form PDF.
- 2
Complete The Form
Enter the requested case, payer, and credit card details, then sign and date the form.
- 3
Gather The Photo ID
Include a copy of a photo ID for the person paying the fine.
- 4
Submit To The Court
Submit the entire form to the court using the address, fax, or email listed on the form.
Frequently asked questions
- Do I need a notary for the Credit Card Authorization Form?
- No. Sign and date the form without a notary. Include a copy of the payer’s photo ID; the form does not require a notarized attachment.
- How do I submit the Credit Card Authorization Form?
- Submit the entire form to the court at 26 Grange Hall Road, Stephentown, NY 12168, or use the fax or email listed on the form. Payment is not accepted by phone.
- What should I include with the form?
- Include a copy of a photo ID for the person paying the fine. The form says payment will not be processed without it, and asks for the case or ticket number.