*I

* authorize John C. Schleiffarth, P.C. to charge my credit card indicated below for

*on the

* off each

* for payment of my legal fees and expenses as agreed upon in my Engagement Agreement. I understand that this authorization will remain in effect until I cancel it, and I agree to notify John C. Schleiffarth, P.C. in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. For ACH debits to my checking/savings account, I understand that because these are electronic transactions, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates. In the case of an ACH Transaction being rejected for Non-Sufficient Funds (NSF) I understand that John C. Schleiffarth, P.C. may at its discretion attempt to process the charge again within 30 days. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I certify that I am an authorized user of this credit card/bank account and will not dispute these scheduled transactions with my bank or credit card company; so long as the transactions correspond to the terms indicated in this authorization form.

I Agree

* Typing your name below signifies acceptance of this agreement.

* Date

* Email Address

(A copy of this consent form will be sent to the email address listed above.)