Nationwide Process Servers Credit Card Payment

Firm or Company Name *
Completed by *
Mailing Address *
Phone Number *
Email Address *
Name on Credit Card *
Credit Card Type *
Credit Card Number *
Expiration Date *
Security Code (on back) *
What is this payment for? *
Name of Company or Person being Served/Subject Name: *
Service Fee or Invoice Total *
This is the amount for the SERVICE you have selected
Fax/Email/Upload Fee (per page) *
Add the PRINT FEE .10 cents for each page you are attaching to this order
Credit Card Processing Fee (5%) *
Add the SERVICE fee and FAX fee together for the Sub Total Amount and then add the 5% Credit Card Processing Fee to the Sub Total to get the Total Amount of this Order.
Total Fee (to be charged) *
I understand and agree that if I miscalculated the total amount for this order or if I didnít select the correct service option for my "deadline" date; Action Process Service will make the correct adjustments and charge this credit card accordingly without notice. *
I pre-authorize Action Process Service to charge all future Orders to this Credit Card, with no advance notice. *
Repeat Clients: In an effort to avoid entering your credit card for each order, you can complete a "one time" credit card order form and check the pre-authorization to charge all future orders to the credit card on file.
Signature (type name) *
Email *
Image Verification
captcha
Please enter the text from the image:
[Refresh Image] [What's This?]