SIRE BUYER

PAYMENT FORM

Payment Method

Please choose your payment method. If you’d like to avoid the 4% surcharge, be sure to mail in your payment (PO BOX 112, Seward, NE 68434)

Sire Buyer Payment Form (Credit Card)

Step 1 of 2 - Contact Information

Hidden

Next Steps: Install the Stripe Add-On

To accept payments on this form you will need to install the Stripe payment add-on. Important: Delete this tip before you publish the form.

Name

First Last

Email

Payment Amount(Required)

Please enter the amount you wish to pay

4% Charge

Price: $0.00

Billing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Total

Credit Card

Card Details

Cardholder Name

Step 1 of 2 - Contact Information

Hidden

Next Steps: Install the Stripe Add-On

To accept payments on this form you will need to install the Stripe payment add-on. Important: Delete this tip before you publish the form.

Name

First Last

Email

Payment Amount(Required)

Please enter the amount you wish to pay

Billing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Bank Name

Bank Routing Number

Bank Account Number

Confirm Bank Account Number