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Payment Authorization

Please PRINT the following
form and mail or FAX to:
    Sermons Online Billing
    10241 Stratford Ave
    Fairfax, VA 22030



    FAX: 1-213-402-2459    

Church Name

 

Sermons Online Account ID

 

Pay via PayPal Account
Fill in the following form to pay for your Sermons Online charges with your PayPal account:

PayPal Login Email

 

PayPal Password

 

Pay via Credit Card
Fill in the following form to pay for your Sermons Online charges with your credit card. (If you have a PayPal account assigned to your credit card, you must either pay via PayPal, or use a different credit card than the one you have assigned to PayPal.)

Card type

  Visa MasterCard American Express Discover

Credit Card Number

 

Verification Number

 

Expiration Date

 

Name (as it appears on card)

 

Billing Address

 

City

 

State

 

Zip

 

Country

 

Email Address (used to send receipt)

 

Telephone Number (used with card)

 

Authorization
I hereby authorize Sermons Online to use the above Billing Information to automatically pay for charges incurred by the Sermons Online service.

Signature