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Make a Payment
Make a Payment
Sam Lombardi
Conveniently pay your outstanding invoice with our secure online payment portal! Complete the form below, and include an invoice number (if applicable) that you would like to apply this payment towards.
Upon completion, you will receive a payment confirmation at the email address you provide.
Customer Information
Name
*
First
Last
Email
*
Phone
*
Payment Information
Invoice Number
Payment Amount
*
Payment Method
*
American Express
Discover
MasterCard
Visa
JCB
Card Number
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
Expiration Date
Security Code
Cardholder Name
Total Payment Amount
$0.00
Acknowledgement
*
I authorize charges to my credit card for the amount specified above.
Signature
*