SECURE PAYMENT FORM

Please complete your transaction by providing payment information below. All information is submitted and handled securely via Netscape's secure protocol, SSL (Secure Socket Layer).

You will receive an email confirmation of your transaction.
BILLING ADDRESS INFORMATION
First Name: Last Name:
Address:
City: State: Zip:
Country:
Phone Number:
E-Mail Address:
CHECKING ACCOUNT PAYMENT OPTION
 At the bottom of your check is a series of numbers, separated by symbols. It is not necessary to enter symbols or spaces in the fields provided below.
Enter the series of nine numbers
between this symbol
Enter the series of numbers
found before this symbol
Dollar Amount
Check number to use: (Not required.)
Note: Some banks use a non-standard format in this series of numbers. If your account number includes this symbol , simply disregard the symbols and enter this section of numbers.
This transaction will be processed in REAL-TIME.
Your transaction will complete in 25 seconds to two minutes, depending on network traffic. In some cases, it may take longer. If your browser supports JavaScript, a timer will count up from zero. Please be patient. Your information is being encrypted for your protection.

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