![]() ![]() CREDIT CARD |
Submit Parameters
I am the customer
I am submitting on behalf of the customer
|
Processor Contact: http://globalpaymentsinc.com
800.622.2318 http://mercurypay.com
800.846.4472 |
||
Required Site Info --> |
|
|||
Your Name |
![]() |
|||
Customer Email (required) |
![]() |
|||
Submitter Email (required)
|
![]() |
|||
Site Name |
![]() |
|||
Country | ||||
Site Address |
![]() |
|||
City |
![]() |
|||
State | ||||
Zip |
![]() ![]() |
|||
Merchant # |
* Variable![]() |
![]() ![]() Info Here
![]() ![]() Info Here
|
||
Bank # |
* 6 digits![]() |
![]() ![]() Info Here
![]() ![]() Info Here
![]() ![]() Info Here
|
||
Time Zone |
Processing...!
![]() |
|||
USE TOKENIZATION? |
||||
Accepted Cards |
Visa/MC
Discover
JCB
Amex
Diners
GIFT
|
|
||
Notes |
|