GNPEC-TGTF

Payment

Payee Information

Billing Address

Payment Information

CREDIT/DEBIT Accepted Cards:

Card Verification Code (CVV/CID):These three or four digit numbers help ensure that the physical card is in the cardholder’s possession while shopping online helping to prevent unauthorized or fraudulent use. The 3-digit code is located on the BACK of the card for Visa, MasterCard and Discover.

ACH/CHECK


Today, being 8/11/2020, I, , by entering my routing and account number above and clicking “Authorize,” I authorize my payment in the amount indicated above to be processed as an electronic funds transfer (EFT) or draft drawn from my checking or savings account as indicated above and, if necessary, to have my account electronically credited to correct erroneous debits. I understand that my payment will be processed within 1 - 2 banking days. If the payment returns unpaid, I authorize you or your service provider to collect the payment and my state’s return item fee and, if applicable, costs, by EFT(s) or draft(s) drawn from my account. Click here to view your state’s returned item fee and, if applicable, costs. I understand that this authorization will remain in full force and effect until I notify you that I wish to revoke it by calling and allow you reasonable opportunity to act on my notice.
PLEASE PRINT A COPY OF THIS PAGE FOR YOUR RECORDS. ALTERNATIVELY, CONTACT US AT [ClientContactNumber] TO LEARN HOW YOU CAN OBTAIN A COPY.
Transaction Summary
A convenience fee will be charged by a third party processor:
3.25 % of the total application fee for Credit Card transactions.
3.25 % fee per transaction for E-check transactions.