Payment Information

Submit your information for invoice payment.

Credit Card Authorization Form

Payment

Name *

Phone *

Address *

Email *

Invoice/Reference Number *

Amount *

Type of credit card: *

Visa

MasterCard

Amex

Credit Card number *

Exp Date *

Code on back *

Please set up my account for automatic payment

Yes

Account Name and Address *

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By submitting this form you authorize Imperial Cleaning Corporation d/b/a Global Services to charge your credit card as indicated above. *

Yes, I agree