Centennial Law - Business Citadel Enrollment

Congratulations, you have elected to receive the legal security and value afforded by the Business Citadel Limited plan. You will receive a confirmation letter in 7-10 days containing instructions on how to receive legal services available under your Business Citadel plan. If you need representation prior to receipt of your confirmation letter, please contact us by phone or email.

Enroll in the Business Citadel Limited plan:
Mandatory fields are marked*

CONTACT INFORMATION:

Your name:*

Business name:*

Best contact telephone number:*

Alternate number:

Business address:*

Street address

City, state, and zip code:

Mailing address (if different than street address):

Street address or P.O. Box

City, state, and zip code:

Email address:*

Fax #:

If we need to contact you, the best time is:

BUSINESS INFORMATION:

Number of employees:*

Year business was established:*

How many locations does your business have?*

Structure of business:*

Annual gross sales:

Types of products or services your business offers:*

If known, please briefly describe the types of legal services you foresee your business requiring in the next 12-months:

PAYMENT INFORMATION:*

You may elect to pay the Business Citadel plan retainer fees in either monthly payments or by a single annual payment. Either option includes a one-time $55.00 set-up fee. A 5% discount is automatically applied to the single annual payment option. The monthly or annual payment options are as follows:

Monthly payments: First payment of $75.00, eleven monthly payments for $20.00.
Annual payment: One-time payment of $283.00 (5% discount applied).

Bank information:*

For your convenience, ACH (electronic check) payment is available in lieu of mailing in a physical check. Your payment will be processed by A-E Trade, Inc. The information necessary to set up an e-check is available from the face of your checks. If you have selected monthly payments, you may change your bank account information at any time by logging into your client profile page (instructions are included with your confirmation letter).

Your business or personal name as printed on your checks:

Address printed on your checks:

Select address or enter new address below:

Street address or P.O. Box

City, state, and zip code:

Name of bank:

Nine-digit routing number:

Account number:

Authorize a payment amount (including one-time $55.00 set-up fee):

An ACH debit (e-check) payable to A-E Trade in the amount authorized will debit from your account no sooner than 3-business days from today's date. If you have elected to make monthly payments, 11 additional debits for $20.00 will post to your account each month for your annual Business Citadel plan.

CONTACT INFORMATION:
Your name:*
Business name:*
Best contact telephone number:*
Alternate number:

Business address:*
Street address
City, state, and zip code:

Mailing address (if different than street address):
Street address or P.O. Box
City, state, and zip code:
Email address:*
Fax #:
If we need to contact you, the best time is:

BUSINESS INFORMATION:
Number of employees:*
Year business was established:*
How many locations does your business have?*
Structure of business:*
Annual gross sales:

Types of products or services your business offers:*


If known, please briefly describe the types of legal services you foresee your business requiring in the next 12-months:



PAYMENT INFORMATION:*
You may elect to pay the Business Citadel plan retainer fees in either monthly payments or by a single annual payment. Either option includes a one-time $55.00 set-up fee. A 5% discount is automatically applied to the single annual payment option. The monthly or annual payment options are as follows:
Monthly payments: First payment of $75.00, eleven monthly payments for $20.00. Annual payment: One-time payment of $283.00 (5% discount applied).

Bank information:*
For your convenience, ACH (electronic check) payment is available in lieu of mailing in a physical check. Your payment will be processed by A-E Trade, Inc. The information necessary to set up an e-check is available from the face of your checks. If you have selected monthly payments, you may change your bank account information at any time by logging into your client profile page (instructions are included with your confirmation letter).

Your business or personal name as printed on your checks:
Address printed on your checks:
Select address or enter new address below:
Street address or P.O. Box
City, state, and zip code:

Name of bank:
Nine-digit routing number:
Account number:
Authorize a payment amount (including one-time $55.00 set-up fee):

An ACH debit (e-check) payable to A-E Trade in the amount authorized will debit from your account no sooner than 3-business days from today's date. If you have elected to make monthly payments, 11 additional debits for $20.00 will post to your account each month for your annual Business Citadel plan.