Secure Credit Card Payment

[Paypal is deprecated by this secure form]

Payment
This is the name of the client with the firm. PLEASE BE SPECIFIC. If the firm represents multiple clients, please identify the client and do each client separately, one at a time.
Cardholder Name
Cardholder Name
First
Last
Card on File
Select this option only if there is a valid CC on file with the firm. The last valid card will be used.
You may leave this field blank only if we have a valid CC Number on file.
This is a three digit code on back of card, except AMEX is a four digit on the front of the card.
You may leave this field blank only if we have a valid CC Number on file.
Autopay Request
We can use this card or the card already on file for autopay so that you do not need to manage the payment. Some clients have multiple cards on file; if this is the case for you, identify the last four digits (eg, x3006) of the specified card already on file in the Special Comments below.
Field not required. If this credit card is, e.g., from other than the client name or at an address not associated with the person or client, this field allows you to indicate special data that may be required for the card not otherwise part of the account. Enter any special instructions.
If you put a 0
If you put a 0 in this field, the amount of your outstanding balance or as stated in the Engagement Letter will be used for the payment. Please do separate payment entries for different client accounts, this entry is for one account only as identified above.
Authorize
By clicking the I Agree button, you are agreeing to pay as identified herein. This is an authorization form, your card will be contacted following submission. Administrative or convenience charges may be added on at the point of charge. You should print this page for your records.
Please check this box to confirm that you are a human being and not spam or a robot.