Electronic Payment Authorization | Jerry R Cole Consulting Group, LLC

Thank You For Your Business

Please enter your payment information below. Jerry R Cole Consulting Group, LLC will use this information to collect payment for the services outlined in your contract. This may include, but is not limited to: website development, licensing fees for images or software, domain name registration, and general hourly consulting.

Name*
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Email*
Phone*
Payment Method*
Credit Card Number*
Security Code*
Expiration Month*
Expiration Year*
Billing Address*
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Authorization*
- I authorize Jerry R Cole Consulting Group, LLC to bill my credit card for services performed, subject to the company's terms and conditions.
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