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In order to protect your privacy and security, we keep your credit card information on our secure gateway.  In order for us to accept credit card payments, you must first register your credit card information with us.

 

This is a one-time registration.  It can be done by calling our office at (401) 737-5055 or faxing our credit card registration form to us.  Click here to open the printable PDF form.

 

 

By submitting this form, you are in agreement with the following:

We hereby authorize Refund Technology to charge our on-file credit card for the amount below.

ALL fields are required:

 
Organization Name:


A/P Contact Name:
 
e-mail Address:
   
  Pay the following UPS refund invoices:
 
My UPS account # is:
 
Invoice #:
Amount:
Comments:
 
Invoice #:
Amount:
Comments:
 
Invoice #:
Amount:
Comments:
 
   
Pay the following FedEx refund invoices:
 
My FedEx account # is:
Invoice #:
Amount:
Comments:
 
Invoice #:
Amount:
Comments:
 
Invoice #:
Amount:
Comments:

 

Total payment amount:

 

General Comments:
 
 
 
 
 
 
 

 

 

 

 

   

 
 
   

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