AMGUS Client Portal Payment / Pago
Choose your membership and one-time services, review the acknowledgements, and complete secure payment with your details.
Need help choosing a service or membership? Chat with Mira / ¿Necesita ayuda para elegir un servicio o membresía? Hable con Mira https://agent.jotform.com/019fe2c8df387000842591cc4ef357dec47a
Customer Information
Full Name / Nombre Completo
*
First Name / Nombre
Middle Name / Segundo Nombre
Last Name / Apellido
Email Address / Correo Electrónico
*
example@example.com / ejemplo@empresa.com
Phone Number / Número de Teléfono
*
Please enter a valid phone number. / Ingrese un número válido.
Format: (000) 000-0000.
HubSpot Contact ID (if known) / ID de contacto de HubSpot (si lo conoce)
Optional / Opcional
Billing Address / Dirección de Facturación
*
Street Address / Dirección
Street Address Line 2 / Dirección Línea 2
City / Ciudad
State / Province / Estado / Provincia
Postal / Zip Code / Código Postal
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country / País
Service Category / Categoría de servicio
*
Please Select / Seleccione
Tax Preparation
Bookkeeping
Notary Services
Apostille Services
Credit & Business Credit
Insurance Services
Document Preparation/Translations
Business Consulting
Construction Referrals & Services
AMGUS Membership
Other
Select the service that best matches your request / Seleccione el servicio que mejor coincida con su solicitud
Service / Membership Selection
One-Time Payment or Recurring Membership Payment / Pago único o pago de membresía recurrente
*
One-time
Recurring
Billing Frequency / Frecuencia de facturación
*
Please select / Seleccione
One-time
Monthly
Quarterly
Annually
Applies to recurring memberships only / Aplica solo a membresías recurrentes
Preferred Payment Method / Método de pago preferido
*
Credit or debit card
ACH bank transfer
Other
Choose Service or Membership / Seleccione Servicio o Membresía
*
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Essential Membership
Monthly membership / Membresía mensual
$29.99
$
29.99
Premium Membership
Monthly membership / Membresía mensual
$59.99
$
59.99
Gold Executive Membership
Monthly membership / Membresía mensual
$99.99
$
99.99
Business Elite Membership
Monthly membership / Membresía mensual
$199.99
$
199.99
Platinum VIP Membership
Monthly membership / Membresía mensual
$399.99
$
399.99
Ongoing Tax & IRS Matter Support Membership
Monthly membership / Membresía mensual
$69.99
$
69.99
AMGUS Late Cancellation / No-Show Fee
One-time fee / Cargo único
$40.00
$
40.00
Business Consultation
One-time service / Servicio único
$310.00
$
310.00
Details
*
Provide details if you selected Other AMGUS Service / Request Quote.
Invoice or Service Reference Number / Número de factura o referencia del servicio
Provide this for one-time service or invoice payments.
Required Acknowledgements and Consent
Please verify your selected service, amount, billing frequency, and acknowledgments before submitting. Payment does not guarantee eligibility, approval, legal representation, insurance enrollment, tax outcome, or completion of a regulated service. / Verifique su servicio seleccionado, el monto, la frecuencia de facturación y los acuses antes de enviar. El pago no garantiza elegibilidad, aprobación, representación legal, inscripción en seguros, resultado fiscal ni la finalización de un servicio regulado.
Required Acknowledgements and Consent / Acuses y Consentimientos Requeridos
*
I acknowledge that refund requests must be made within 15 calendar days / Reconozco que las solicitudes de reembolso deben hacerse dentro de 15 días calendario
I understand that after 15 days, amounts for services used or work performed are non-refundable except where law requires otherwise / Entiendo que después de 15 días, los montos por servicios utilizados o trabajo realizado no son reembolsables salvo que la ley requiera lo contrario
I understand appointments must be canceled or rescheduled at least 24 hours in advance or a $40 fee may apply / Entiendo que las citas deben cancelarse o reprogramarse con al menos 24 horas de anticipación o puede aplicar un cargo de $40
I understand recurring memberships must remain current / Entiendo que las membresías recurrentes deben mantenerse al corriente
I understand that if the $69.99 Ongoing Tax & IRS Support membership becomes delinquent AMGUS may pause or terminate administrative/service support until current / Entiendo que si la membresía de Apoyo Continuo de Impuestos e IRS de $69.99 se vuelve morosa, AMGUS puede pausar o terminar el apoyo administrativo/de servicio hasta que esté al corriente
I understand AMGUS is not a law firm and does not provide legal advice or court representation / Entiendo que AMGUS no es un bufete de abogados y no proporciona asesoría legal ni representación en tribunales
I consent to electronic records and communications / Doy mi consentimiento para registros y comunicaciones electrónicas
Electronic Signature / Firma Electrónica
*
Sign below / Firme abajo
Payment Details / Detalles de Pago
Secure checkout for memberships, fees, and custom requests. If the payment processor is not mapped automatically, applicants will be guided to complete payment through the checkout handoff.
If automatic payment mapping is unavailable, the selected item will be preserved and applicants will be directed to complete checkout through the secure handoff process.
Submission Date & Time / Fecha y Hora de Envío
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Submit / Enviar
Submit / Enviar
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