Form 1

Date(Required)
To: SIA INVESTIGATIONS

1099 E Champlain Drive, STE A-1073, Fresno, CA 93720 on all forms.

TELEPHONE: (877) 574-4411

FACSIMILE: (877) 471-6902



BY USING MY CREDIT CARD SPECIFIED AS:
I understand and acknowledge the charge I hereby authorize for the above-specified services. This payment authorization is for the type of bill indicated above. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company, provided the transactions correspond to the terms indicated in this authorization form. I further agree that, by signing this agreement, I am agreeing to the terms and conditions, and privacy notice, of the website through which I contacted SIA, Inc., and those of all related websites owned and operated thereby.
Your credit card charge will appear as “SIA, Inc.” on your statement.
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