Adobe Lands, Inc Secure Payment Form
Payment Information:
Payment Amount (US$):
Account Number:
Bank Account Information:
Account Holder Name:
Bank Routing Number:
Bank Account Number:
Contact Information (optional):
Your Phone Number:
Your Email Address:
Terms of Service:
Must Be Checked To Proceed:	I am authorized to initiate transactions on the above indicated bank account. I authorize Hawthorne Group, LLC to debit this bank account for the indicated Payment Amount and credit it to the indicated Account(s) at Adobe Lands, Inc.