Payment-options-form-export

1303 10TH Street East
Bldg. C Suite A
Palmetto FL 34221
Phone: 941 567 6232
Fax: 941 981 5106

AUDITING AND INVESTIGATING SERVICES.

CLIENT NAME

AGREES TO PAY (PLEASE LIST DATES FOR PAYMENTS)

$399.00 IN FULL ON DATE

$316.00 FOR 3 PAYMENTS ON DATES (Please enter all 3 dates for each payment.)

$775.00 IN FULL ON DATE

$200.00 FOR 6 PAYMENTS ON DATES (Please enter all 6 dates for each payment.)

Complete the area below to choose monthly installments of $159. Select the date for charge for Down Payment and then select day of the month for future payments.

$159 DOWN PAYMENT PAID ON (insert date)

Select the day of the month for future payments

NAME

There will be a 15.00 dollar late charge every week if payment is not in by the affirmed dates.

After 3 missed payments your file will be closed, YOU will have to restart service*

In order for the business to operate effectively payments need to be made in a timely manner.

PLEASE NOTE YOUR PAYMENTS WILL BE SET UP WITH THE CARD USED TO PAY YOUR $ADMIN FEE
If you would like to use a different card for future payments, select the check box below and submit credit card information.

Use different card for monthly payments.

Name on Card

Card Holder's Adress

Credit Card Number

Expiration

Credit Card CVC # (located on back of Visa and Master cards)

Payment-options-form-export

AUDITING AND INVESTIGATING SERVICES.

AGREES TO PAY (PLEASE LIST DATES FOR PAYMENTS)

There will be a 15.00 dollar late charge every week if payment is not in by the affirmed dates.

After 3 missed payments your file will be closed, YOU will have to restart service*

PLEASE NOTE YOUR PAYMENTS WILL BE SET UP WITH THE CARD USED TO PAY YOUR $ADMIN FEE
If you would like to use a different card for future payments, select the check box below and submit credit card information.

Phone: 941-567-6232 Fax: Fax: 941 981 5106

FOLLOW US

Quick Links

Payment-options-form-export

AUDITING AND INVESTIGATING SERVICES.

AGREES TO PAY (PLEASE LIST DATES FOR PAYMENTS)

There will be a 15.00 dollar late charge every week if payment is not in by the affirmed dates. ****After 3 missed payments your file will be closed, YOU will have to restart service*****

***PLEASE NOTE YOUR PAYMENTS WILL BE SET UP WITH THE CARD USED TO PAY YOUR $ADMIN FEE *** If you would like to use a different card for future payments, select the check box below and submit credit card information.

Phone: 941-567-6232 Fax: Fax: 941 981 5106

FOLLOW US

Quick Links

There will be a 15.00 dollar late charge every week if payment is not in by the affirmed dates.

After 3 missed payments your file will be closed, YOU will have to restart service*

PLEASE NOTE YOUR PAYMENTS WILL BE SET UP WITH THE CARD USED TO PAY YOUR $ADMIN FEE
If you would like to use a different card for future payments, select the check box below and submit credit card information.