Manual Credit Card Payment

Please enter the amount you are charging in the box below.

Authorized Amount

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Payment Type

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Card Holders Name

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Credit Card Number

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Address

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Address 2

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City

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State

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Zip

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Expiration Date

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Please enter the credit card CVV (Card Verification Value). This is the 3 digit number usually on the back of your Visa, MasterCard, Discover Card. On your American Express Card it is a 4 digit number usually on the front of the card.

CVV2 Security Code

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Telephone Number

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Email

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CVV2/Security CodeWhat is this? The Security Code is a 3 or 4 digit code printed on your credit card. We require this code as a security measure to our customers. Requiring this information helps to ensure that the credit card is present at the time of use. If you cannot find this code, or it is illegible, please contact your credit card issuer. Visa/Mastercard/Discover: The Security Code is the 3 digit value printed on the signature panel located on the back of your card. It is the last 3 numbers in that area. American Express: The Security Code is the 4 digit value printed (not-embossed) above your account number on the front of your card.

Are you Human(*)

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