Secure Credit Card Payment Form

Thank you for using AirTight FaciliTech's credit card payment form. If you have any questions or prefer to pay by phone, please call our office at 704-568-4121, option 2.

Please note that only ten invoices may be paid at a time. If you are paying more than ten invoices, please complete this form and then open again to pay additional invoices.

	Enter:
Name	Enter:
Company Name	Enter:
Phone Number	Enter:

Enter 1st invoice number *

Enter 1st invoice amount: *

Add a 2nd invoice to pay?

Yes

Enter 2nd invoice number *

Enter 2nd invoice amount: *

Add a 3rd invoice to pay?

Yes

Enter 3rd invoice number *

Enter 3rd invoice amount: *

Add a 4th invoice to pay?

Yes

Enter 4th invoice number *

Enter 4th invoice amount: *

Add a 5th invoice to pay?

Yes

Enter 5th invoice number *

Enter 5th invoice amount *

Add a 6th invoice to pay?

Yes

Enter 6th invoice number *

Enter 6th invoice amount *

Add a 7th invoice to pay?

Yes

Enter 7th invoice number *

Enter 7th invoice amount *

Add a 8th invoice to pay?

Yes

Enter 8th invoice number *

Enter 8th invoice amount *

Add a 9th invoice to pay?

Yes

Enter 9th invoice number *

Enter 9th invoice amount *

Add a 10th invoice to pay?

Yes

Enter 10th invoice number *

Enter 10th invoice amount *

Please note that only ten invoices may be paid at a time. If you are paying more than ten invoices, please complete this form and then open again to pay additional invoices.

Subtotal before Convenience Fee:

0.00

Convenience Fee - 2.75%

0.00

If provided by ATFT, please enter code here. Otherwise, leave blank.

Convenience fee reduction

0.00