Please Select A Customer. Please make a selection Total Amount Due: Step1: Payment Type Please select the payment type Check Cash Credit Card - Square Credit Card - Paypal Credit Card - Offline Is this payment for the diagnostic fee only? Step2: Payment Amount (This amount can be changed in order to make a partial payment) A 3% Fee Will Be Applied: Amount to be processed today: Cash Recieved From Customer: Change Due: Check Number: Scan Check: Name on card: Last name: Card type: (Select card type) American Express Visa MasterCard Discover Card number: Expiration date: Month: Year: CVC Code: Step3: Collect PSA Info Active PSA Found. Payment & Signature Required. Agreement Number Record PSA Payment & Signature? Payment Type: (Select payment type) Credit Card E-Check No PSA Information To Collect At This Time Name on card: Card type: (Select card type) American Express Visa MasterCard Discover Card number: Expiration date: CVC Code: Account Number: Routing Number: Step4: Customer Signature
