Products Price Quantity Total

Products		Price	Quantity	Total
My Community Legal Gold Plan + Business Protection Rider Plan $240.00 / year for 2 years	$240.00	1	$240.00
Subtotal			$240.00

My Community Legal Gold Plan + Business Protection Rider Plan

$240.00 / year for 2 years

$240.00

Subtotal $240.00

Billing Information

* First Name

* Last Name

Company Name

* Address - Line 1

Address - Line 2

* City

* State

* Zip Code

* Country

* Phone Number

* Email Address

Order Summary

Subtotal $240.00

Order total $240.00

Order Summary
Subtotal	$240.00
Order total	$240.00

Payment Information
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Credit Card Type	Credit Card Number	Expiration Date	Security Code

Payment Information

Credit card

Credit Card Type

Credit Card Number

Expiration Date

Security Code

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