A.N.D. Technologies Transaction Payment
  Customer information
 
First name:
Last name:
Phone number:
Email address:
Company name:
 
  Billing information
 
Address:
 
City:
State/Province:
Zip/Postal code:
Country:
 
  Transaction information
 
Transaction Type:
Transaction #:
Transaction Amount:
Notes:



 
  Shipping information
 
  Same as billing information.
Address:
 
City:
State/Province:
Zip/Postal code:
Country:
 
  Payment information
 
Credit card type:
Card number:
Expiration date:  
Cardholder name:
3 digit security code:
(Visa/Some Mastercards)
 
  Notice
 
 
  • This is a secure online payment page; however, your payment will be handled by a person.
  • All information submitted here will only be sent over a secure connection.
  • An email will be sent to you immediately confirming that the order for payment has been received.
  • Payments will only be accepted from the US and Canada, and from countries where there is not an authorized reseller.