Nationwide Purchase and Recovery of Real Estate Deficiencies,
Liens and Promissory Notes

Credit Card Payment Form >>>

Credit Card ePayment
Message:

Items marked with () are required.

Debtor Information
Debtor Account Number:
Client Name:
Name: (first last)
Address:
City/State/Zip:
Phone:
Email: (your receipt is sent to this address)

Credit Card Information Note: This address must match the address where the credit card statement is mailed. Providing incorrect information will cause the transaction to be declined, however, a temporary "Hold of Funds" may be placed on your credit card for a length determined by the card issuing bank (an average length of 7 days).

Payor (must be the cardholder) [Same as Above]
Name: (as it appears on the card)
Address:
City/State/Zip:
Phone:
Email: (your receipt is sent to this address)
Card Type:
Card Number:
Expires: - (mm-yyyy)
Card Verification (cvv2): [What's This]

Payment Information
Amount to Pay:
Please: No dollar signs or commas. Only digits and a single decimal point (e.g., 50.00)
Payment Processing Fee:
Total Charge:
I accept the fee shown above -and- the 'Total Charge' that will be billed to my card.

Contract

You are about to request a payment be made electronically using your credit card. You must agree to the following.

  1. Credit card transactions are processed by Educational Billing Services (EBS), through their EPay service. Your credit card statement will reference "Educational Billing Services, LLP" as the payee. EBS charges a payment processing fee of for all payments made through their service. The charge is calculated and displayed above for your convenience.
  2. I authorize a charge to the above specified credit card.
  3. Should this transaction fail for any reason (including invalid account numbers, chargeback, etc.) I understand that additional penalties, fees and interest may accrue.
  4. By completing and submitting this form, I affirm that:
    1. I have read, understand and agree to be bound to the terms of this agreement
    2. I am authorized to perform this transaction by the legal party to the debt(s)
    3. I am authorized to perform transactions using the card information provided


By checking this box, I certify, under penalty of law, that the information provided is correct -and- that I accept the terms of this agreement as presented in the contract.

[I Accept] [Quit]