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Make a Debit Card Payment

(For Clients Only!)

Please enter information on this form to make payment for Make a debit card payment (clients only) . The amount you need to pay is $0.00 .

First Name *
Last Name *
Organization
Address *
Address2
City *
State *
Zip *
Country
Phone *
Email *
Amount *
Comment
I am a client of *
Last 4 of Social * Please enter the last 4 numbers for the client's social security number.
Please Be Aware: If you are a client intending to file bankruptcy, you CANNOT pay your fees with a credit card. We can only accept debit cards.
However, if a third party is paying your fees, a credit card may be used. A third-party can make a credit card payment by using the form that is located in the right column.
Credit Card Number*
Expiration Date*	/
Card (CVV) Code*
Card Type*
Card Holder Name*
Bank ABA Routing Number*
Bank Account Number*
Bank Account Type*
Bank Name*
Account Holder Name*