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  • PAYMENT INFORMATION REQUEST FORM

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    Credit Card

  • Please Note: Credit Card transactions are processed through a third-party vendor which assesses a non-refundable processing fee of 2.9% + .30 per transaction, if you use this form. Payment by phone is 3.5% + .30.  For eCheck, the fee is 1% up to max of $15 and there may be up to a 5-day wait until the payment has cleared your bank and posted with PIA, Inc.

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