Personal Assistance Services
PASA Online Payment Portal
Client Name
*
First Name
Last Name
Client Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
A receipt will be sent to this email address
Invoice Number
*
Invoice Amount
*
Notes:
Please share any additional information you think would be helpful
Amount to Pay
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USD
Please enter the amount you are paying
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
ACH Bank Transfer
Submit
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