"First Name" field is required.

"Last Name" field is required.

"Street Address" field is required.

"City" field is required.

"ZIP Code" field is required.

"State" field is required.

"Country" field is required.

"Payment Method" field is required.

"Cardholder Name" field is required.

"Card Number" field is required.

"Expiration Date" field is required.

"Security Code" field is required.

ERROR: Please verify your payment options.

Billing

First Name *

Last Name *

Street Address *

City *

ZIP Code *

State *

Country *

Credit Card

Payment Method *

Payment Method * New Credit/Debit Card

Cardholder Name *

Card Number *

Expiration Date *

Security Code *

Save Credit Card

I authorize Holmes County Sewer to automatically charge the payment method listed above on the bill day below.

Select Recurring Payment Date:

Billing

First Name *

Last Name *

Street Address *

City *

ZIP Code *

State *

Country *

Credit Card

Payment Method *

Payment Method * New Credit/Debit Card

Cardholder Name *

Card Number *

Expiration Date *

Security Code *

Save Credit Card

I authorize Holmes County Sewer to automatically charge the payment method listed above on the bill day below.

Select Recurring Payment Date:

Acct 320

Pay Invoice

MAST, ROD

5325 CR 626 PO BOX 208
BERLIN, OH 44610

Holmes County Sewer

Mary Troyer
7191 OH-39
Millersburg, OH 44654
US

Date: June 15, 2020

Invoice Number: 6028

Invoice Due: June 29, 2020

Invoice Total: $61.76

Balance: $61.76

Task

Amount

Service Address:

5325 County Road 626

Berlin, Ohio 44610

$0
Service

Price

%

Amount

Monthly Commercial Rate

$60.02

0%

$60.02

Payment Pending

Notes

Thank you; we really appreciate your business.

Terms

We do expect payment within 21 days, so please process this invoice within that time. There will be a 1.5% interest charge per month on late invoices.