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
Please print, complete,
and fax our credit card registration form to us.
Click here to
the printable PDF form.
To pay amounts of
$10.00 or more by credit card, please complete the
form below and click the submit button.
By submitting this form, you
authorize Refund Technology to
charge your on-file credit card for the amounts below.