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It is designed specifically for MCLE (Minimum Continuing Legal Education) providers to process payments for certification-related fees, including single activity provider applications, multiple activity provider applications, and renewals. The form requires essential payment details such as cardholder information, card number, security code, expiration date, and billing address. It explicitly stipulates that a non-refundable 2.5% service fee is applicable to all credit and debit card transactions processed through this channel. Users must note that this form is strictly for MCLE provider certification fees and cannot be utilized for the payment of attorney dues or other miscellaneous legal fees. Completed forms must be submitted to the State Bar of California office in San Francisco.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/mcle-provider-credit-card-authorization-form/286721/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/mcle-provider-credit-card-authorization-form/286721.png","ImageObject",442,249,{"name":88,"@type":89},"Quinn","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-23","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":79},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"Can this form be used to pay my annual attorney dues?","Question",{"text":108,"@type":109},"No, this form is strictly reserved for fees related to MCLE Provider Certification and cannot be used for attorney dues or other legal fees.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What is the additional service fee for credit or debit card payments?",{"text":113,"@type":109},"A non-refundable service fee of 2.5% is added to all charges and collected by the credit card processor.",{"name":115,"@type":106,"acceptedAnswer":116},"Which types of cards are accepted for payment?",{"text":117,"@type":109},"The form accepts credit and debit cards capable of being run as credit, specifically Visa, MasterCard, American Express, and Discover.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},286721,1789631472,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":79,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":125,"read_time":4},962075114765,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","OFFICE OF ATTORNEY REGULATION & CONSUMER RESOURCES  \n180 Howard Street, San Francisco, CA 94105 888-800-3400 [AttorneyRegulation@calbar.ca.gov](AttorneyRegulation@calbar.ca.gov)  \nMCLE PROVIDER CERTIFICATION  \nCREDIT CARD AUTHORIZATION FORM  \nDate:  \nI authorize the State Bar of California to charge my credit card for $  \nPlease check which fee you are paying:  \nSingle Activity Provider Application Multiple Activity Provider Renewal  \nMultiple Activity Provider Application  \n(This form may not be used to pay dues or other attorney fees; it only may be used to pay fees related to MCLE Provider Certification. )  \nFor credit and debit card payments, a non-refundable service fee of 2.5% will be added to all charges and collected by our credit card processor. Only debit cards capable of being run as credit, such as Visa or MasterCard, can be used for payment and subject to the service fee of 2.5% .  \nCredit Card Number:  \nCredit Card Security Code: Expiration Date:  \nCheck Credit Card Type: Master Card Visa Address:  \nForeign Address (if applicable):  \nCity, State, Zip:  \nAmerican Express  \nMonth/Year  \nDiscover  \nSignature of Card Holder:    \nName of Provider:(Please Print)  \nE-Mail:  \nTelephone \\#:  \nPlease submit to: The State Bar of California  \nMCLE Provider Certification  \n180 Howard Street  \nSan Francisco, CA 94105-1617  \nmcleproviderccauth.0419","cbCaieilsirjzFYp","https://ap.wps.com/l/cbCaieilsirjzFYp","pdf",661326,"English","# Payment Authorization\n## Fee Selection\n## Credit Card Details\n## Provider Information","[{\"question\":\"Can this form be used to pay my annual attorney dues?\",\"answer\":\"No, this form is strictly reserved for fees related to MCLE Provider Certification and cannot be used for attorney dues or other legal fees.\"},{\"question\":\"What is the additional service fee for credit or debit card payments?\",\"answer\":\"A non-refundable service fee of 2.5% is added to all charges and collected by the credit card processor.\"},{\"question\":\"Which types of cards are accepted for payment?\",\"answer\":\"The form accepts credit and debit cards capable of being run as credit, specifically Visa, MasterCard, American Express, and Discover.\"}]","MCLE Provider Credit Card Authorization Form | PDF"]