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Advertising Remittance

Please use the following form to pay for advertising with your credit card securely.
Payment of an individual advertising invoice

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Amount The amount of your transaction

Amount * $ Please fill out this field. Please enter a positive decimal.

Schedule The frequency of your transaction

 One-Time

 Monthly

Frequency * Please fill out this field.

Begin on * Please fill out this field. Please enter a date. 

You will be charged today.

You will be charged once a month. Your first charge will occur on .

Details Additional information

Advertiser No.
Refer to top of invoice for your number
Please enter valid data.

Invoice No.

Billing Information Payment method details

First Name * Please fill out this field. Please enter valid data.

Last Name * Please fill out this field. Please enter valid data.

Billing Address Please enter valid data.

City Please enter valid data.

State / Province * Please fill out this field. Please enter valid data.

Zip / Postal Code * Please fill out this field. Please enter valid data.

Email * Please fill out this field. Please enter an email address.

Phone Number Maximum 20 characters Please enter a phone number.

 Credit

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Summary Confirm transaction details

Offset Fees? I'd like to add 31% to offset processing fees

Amount 0

One-Time Details Recurring Details
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