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Payment Information
Pmt Method:
Ref # :
Credit Card Number:
Expiration Date:
CVV:
Name on Card:
Street Address:
ZIP:
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Enter credit card information
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Your information is secure.
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1234
I understand that you, Customer Name, agree to let Company Name electronically debit your bank account or create and process a demand draft against your bank account in the amount of $123.67on or after today's date, mm/dd/yyyy.
I will (mail or email) you a confirmation of this transaction. If you have any questions, please contact name at contact info.
To get verbal consent, read the following authorization statement aloud to your customer.
<QUICKBOOKS PAYMENTS HELP TOPIC TBD>
<CARD SWIPE HELP TOPIC TBD>
Swipe Card Now...
Reading Card...
NOTE: CREDIT CARD IMAGE CHANGES BASED ON WHETHER OR NOT MERCHANT HAS AMEX PROCESSING CAPABILITY.
NO AMEX:
AMEX:
