Payment Autorization
Company Name
Payment Type
AUTOPAYMENT
PAY ONE INVOICE
As a duly authorized account signer on the financial institution account identified below I / We authorize Armada Labs LLC to automatically charge my CREDIT CARD or CHECKING ACCOUNT. This authority will remain in effect until I give reasonable notification to terminate this authorization or until the last specified payment date.
As a duly authorized account signer on the financial institution account identified below I / We authorize Armada Labs LLC to charge my CREDIT CARD or CHECKING ACCOUNT in the amount specified below.
Invoice Number
Amount
Billing Contact
Name
Address
City
State
--- select state ---
Alaska
Alabama
Arkansas
American Samoa
Arizona
California
Colorado
Connecticut
District Of Columbia
Delaware
Florida
Federated States Of Micronesia
Georgia
Guam
Hawaii
Iowa
Idaho
Illinois
Indiana
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Kentucky
Louisiana
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Maryland
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Puerto Rico
Palau
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Virgin Islands
Vermont
Washington
Wisconsin
West Virginia
Wyoming
ZIP Code
Payment Info
CREDIT/DEBIT CARD
CHECKING/SAVINGS
We impose a surcharge of 2.5% on the transaction amount on all credit card products, which is not greater than our cost of acceptance.
Card Number
Expiration Date
CVV
Bank Routing Number
Account Number
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