Joplin Payment | tel-a-rent

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JOPLIN LOCATION

PAYMENTS ARE MANUALLY PROCESSED UPON RECEIPT. PAYMENT INFORMATION WILL BE RECEIVED IMMEDIATELY AND CREDIT WILL BE APPLIED TO ACCOUNT UPON APPROVAL OF CREDIT CARD. TRANSACTION MAY TAKE 24 HOURS TO PROCESS. THANK YOU!

First Name

Last Name

Name on Account

E-Mail Address

Phone

Billing Zip Code

CARD TYPE

Card Number

EXP MONTH

EXP YEAR

CVV #

Amount to Pay

DO YOU HAVE SPECIAL INSTRUCTIONS ON HOW TO APPLY YOUR PAYMENT? PLEASE EXPLAIN BELOW.

FEE CHANGE NOTICE: I hereby authorize Tel-A-Rent Inc., central office located in Springfield Missouri) to initiate a charge from my credit/debit card. I agree that I am fully authorized to use and initiate this transaction on the card provided. I understand that if this is a debit card the charge may be debited from my institutions ATM/ACH network. In the event that a credit entry is made in error, I will provide Tel-A-Rent Inc. with proof of the error so that it may be reviewed and corrected. Further, I agree to not hold Tel-A-Rent Inc., Springfield, Missouri responsible for any delays, or loss of funds due to incorrect or incomplete information supplied by me or my financial institution or due to an error on the part of my financial institution in depositing funds to my account. I agree not to hold Tel-A-Rent Inc. liable for loss of data. I am aware that an online processing fee will be charged along with the principal payment. The online payment credit card fee schedule is as follows: ($0-49 = $1 fee) ($50+ = 3% fee as of 01/01/20). I understand that by providing my electronic signature, I UNDERSTAND AND AGREE to the statements and fee schedule aforementioned. *

Make payments worry-free! Enroll in AUTOPAY!

Ask your store manager today or download Auto Debit form below and fill out. Return by e-mail, scan, or in person.

AutoDebit.pdf