Estimate Payment Form-CC

AV Now's Quote or Invoice Payment Form
Please enter the required payment information and click 'Submit'. Contact us with any questions or issues. Email us at sales@avnow.com or call us at 800-491-6874 (M-F 8-4pm PT)

Ship To Name:*

First NameLast Name

Business Name if applicable:

E-mail:*

Quote or Invoice Number:*

Found in the upper right hand side of your Quote or Invoice.

READ THIS FIRST:
Note about billing and shipping addresses.
The address entered below is for billing purposes only and does not reflect the shipping address for the order. Please refer to your quote or draft order to view the shipping address for the order and let us know if any updates are required.

Estimate Total-*

USDPayment Amount

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing address for credit card:

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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