Secure Payment Form Customer Account(Required)Please enter the Company name of the qnectU Customer account the payment will be applied to.Cardholder Name(Required)Please enter the name as it appears on the Credit Card. First Last Email Address(Required)Please enter the email address where you want the payment receipt sent. Card Billing Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Card Billing Phone Number(Required)Credit Card(Required)Configuration Required: To use the Stripe field, please configure your Stripe Settings. Invoice Number(s) Being PaidEnter one or more Invoice Numbers that you are payingAmount Being Paid(Required)Enter the total amount of all Invoices being paid. This is the amount that will be credited to your account. (This amount is the subtotal before the Credit Card Convenience / Processing Fee and will be 97% of the total charge.) Fee(Required)The Convenience / Processing Fee is 3% of the Total amount being charged to the card. Price: $0.00 Total
