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Payment Authorization

If you experience any errors with the form below, please contact our billing department at (586) 405-8124 or [email protected].

"*" indicates required fields

Your Name*

Email*

Company Name*

Card Authorization Usage

Select all that apply.

Hosting & Support Fees

Campaign Management Fees

Search Advertising Spend (Google/Bing)

Payment Type*

Credit or Debt Card

Bank Account (ACH)

Please note: At this time, we currently only allow search campaigns to pay for ad spend on a credit card. If you need to provide an additional method of payment, you will be provided the opportunity to do so after submitting this form.

Credit Card Number*

Name on Card*

Card Type*

Expiration Date*

CVV*

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Account Number*

Routing Number*

Name on Account*

Account Type*

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