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Fax: [PHONE REDACTED] BANK CARD TRANSACTION FORM This form must be completed and submitted to Planning and Development Department. Transactions cannot be processed unless all information is submitted. Type of Card: Visa Mastercard American Express Discover Payment Amount: (processing fee will be added to final total) Card Number: Expiration Date: Name on Card: Security ID#: Billing Zip Code: Telephone Billing Address: Contact Person: Signature of Card Holder Total Payment: Processed By: Date: PLANNING AND DEVELOPMENT 25 Justice Way I Suite 2322 I Dawsonville, GA 30534 I dawsoncountyga.gov Payment for: (License,Permit,Sign, Inspection fee,LDP,etc SIGN