WELCOME  TO BILL PAY!

We are happy to provide this online system for convenient, quick, and secure payment processing.  Thank you for allowing us the opportunity to serve you.

Full Name on Card:
PO or Invoice Number:
PO or Invoice Amount:
   
Address:
City:
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This form will submit your general user information to our secure payment gateway using SSL encryption technologies, where you can enter your credit card information and send your payment instantly.  Payment will not be processed until you continue to the next screen.

  


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CCAUTH Agreement

For recurring payments, you may also opt to fill out and fax the following Credit Card Authorization Agreement.  Please fax this form to Diversicom Corporation at 813.649.8065.

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