HANDYMAN CONNECTION OF ANN ARBOR
Secure Payment Form
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Order Summary
Order Date
Order Amount
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Surcharge (2.9%)
Total Amount
Description
Credit Card Information
Name as on Card
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Card Billing Address
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Card Billing Zip
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Card Number (Please double-check)
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Card Expiration Date
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CVV2/CID
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Work Order Information
Company Name
First Name
Last Name
Address
Address 2
City
State
Zip
Phone Number
Email Address
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