"First Name" field is required.
"Last Name" field is required.
"Street Address" field is required.
"City" field is required.
"ZIP Code" field is required.
"State" field is required.
"Country" field is required.
"Cardholder Name" field is required.
"Card Number" field is required.
"Expiration Date" field is required.
"Expiration Date" field is required.
"Security Code" field is required.
Card Or Magstripe Required
Notes
Checks paypable to: Cong Khal Milval Serpi
83 Milval Lane Highland Mills New York 10930
Terms
Please review your invoice and make payment at your earliest convenience.
Updated
November 12, 2024 @ 2:27 am
Invoice updated by Ari_Mandel.
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Payment
May 21, 2025 @ 12:17 pm
Credit (Authorize.Net)Payment Total: $100.00
Status Update
May 21, 2025 @ 12:17 pm
Status changed: Pending to Paid.