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Billing Information
Billing Contact Billing Address
Order/Transaction Information
Payment Information
Review & Submit
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Step One
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Billing Information
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Simply enter your name, e-mail and street address. If your a business please enter your company name as well.
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When transaction is complete we will send your an e-mail confirmation.
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John Doe
[email protected]
Billing Contact
Street Address
City
Billing Address
Billing Information
Your Invoice Number
Order/Transaction Information
Payment Information
Review & Submit
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Step Two
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Order/Transaction Information
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Enter your invoice number located on your green invoice from Dye & Doss.
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Payment Information
Please fill in the green fields below
Electronic Check
05/30/2013
Dye & Doss, Inc.
Account Type
Single payment
Total: 100.00
PaymentAmount:
Review & Submit
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Step Three
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Check Information
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Using a blank check enter your routing number, account number and check number. Re-enter your account number and select the account type, checking or saving.
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Enter amount due and continue.
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John Doe
[email protected]
Billing Contact
Street Address
City
Billing Address
Billing Information
Invoice # :
Order/Transaction Information
12345
************1234
PEOPLES SAVINGS BANKPayment Amount: $100.00
Payment Information
Review & Submit
I authorize my account to be charged in accordance to the followingTerms and Conditions for the payment(s) indicated above.
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Step Four
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Review & Submit
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Review payment details and submit your payment.
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Click the edit button to correct any previously entered information
Page 5
Bill To:
John Doe
Street Address
City
[email protected]
Transaction Date: 5/30/2013
Pay Method: ************8533
Approval #: 23939099
Trace Number: 1fe3547a-eb80-49e2-b741-f68c90202edc
Amount: $100.00
Single Payment Payment Amount:
Total:
$100.00
$100.00
Thank you for your payment.
Dye & Doss, Inc.
127 South Main Street
P.O. Box 231
Urbana, OH 43078
Phone: 937-484-3677
Fax: 937-653-4811
[email protected]
Payment Receipt Invoice # : 12345
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Step Five
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Reciept
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Print your payment receipt for your records.
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An e-mail confirmation will be sent to the address provided.
