Promoter Payment Processing

Promoter Payment Processing

Sanction Fees, Licenses, Other Payments
Track/Business Name
Contact Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Invoice Number (if applicable)
Event Date (Use today's date if not applicable)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Sanction Fee Calculation
Select the divisions running:
Modified Purse
Enter your total Modified purse. If you did not run Modifieds, leave this field blank.
5% of Modified Purse
Modified and Stock Car events that pay $1,000 or more to win are potential qualifiers for the All Star races at the Super Nationals. Please indicate if your event paid $1,000 or more in the Modified or Stock Car divisions and was an All Star Qualifiying event.
The following divisions were All Star Qualifying events:
Sanction Fee Total (including 5% of Modified Purse and All Star Qualifier fees, if applicable)
Memberships
Memberships Collected
Enter the total dollar amount owed to IMCA for the memberships you collected. Be sure to send the application forms to us ASAP. Indicate how you will be sending the forms. ***NOTE: It is important that you send membership forms you have collected ASAP to Jodi: JRoot@imca.com
I will be sending membership forms via:

Other
Memberships Collected From:
Enter the name(s) of the driver(s) that purchased licenses.
Other Payments
Payment amount
Enter the total dollar amount to pay, and select what this payment is for from the options below.
Payment for:

Other
Franchise fee for the following divisions:
Subtotal

Payment Total

USDOnline Promoter Payment

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Should be Empty:

Promoter Payment Processing

Sanction Fee Calculation

Memberships

Other Payments

Payment Total