Online Payment Form
BUSINESS COMMUNICATION NETWORK SYSTEMS
(800) 319-9087
Printable Payment Form For Visa and MasterCard Payments
Please call our accounting department at (800) 319-9087 option 3 with your payment information or print a copy of this form, fill out all information and return to TSM South by fax or mail.
All fields are required.
APPROVAL TO PAY INVOICE # : _____________________________
IN THE AMOUNT OF $ : _____________________________________
CREDIT CARD # : ___________________________________________
EXPIRATION DATE : __________
SECURITY CODE (CVV2 – 3 digit code on back of card) : _____
NAME ON CARD : ___________________________________________
ADDRESS WHERE CREDIT CARD STATEMENTS ARE MAILED: _____________________________________________________________
EMAIL OR FAX# FOR RETURN RECEIPT : _____________________________________________________________
Please sign and return completed form to TSM South via fax or mail.
Fax # 919-854-0412 (Accounting Fax)
Mailing Address:
PO Box 2137, Cary, NC 27512
Questions? Contact Accounting (919-532-5362)