Name of Person Submitting Payment
*
First Name
Last Name
Company Name
*
E-mail (for payment confirmation)
*
example@example.com
PDI Invoice Number
*
If paying multiple invoices, include all invoice numbers
Invoice Amount
*
If paying multiple invoices, total amount of the invoices.
Calculation
Calculated Payment Amount
*
prev
next
( X )
USD
Total amount plus a 3.4% + $0.30 convenience fee. Refer to our terms and conditions.
Notes/References:
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Should be Empty: