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5850 Fayetteville Road, Suite 211, Durham, NC 27713 Credit Card Authorization Form Please complete the information below: I authorize Green lee Psychological and Support Services, LLC PRINT NAME (GPS)
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Start by writing your full name. Make sure to use your legal name as it appears on your identification documents.
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Next, provide your complete mailing address. This should include the street address, city, state, and ZIP code. In this case, the address is 5850 Fayetteville Road Suite.
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Specify the suite number after the street address. In this case, it would be written as "Suite" followed by the suite number. For example, "Suite 100".
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Businesses or organizations looking for a physical location to establish their office.
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