On-Line Credit Payment

SH Systems offers its customers the opportunity to pay on-line for products and services, including software and web site development. 

We accept    Visa   MasterCard   American Express  and Electronic Checking.
Note: Your information will be sent securely. 
Please fill out this form regarding your payment.

SHS System, Inc. Account Information:

Name (required)  
Organization
Work Phone   (required)
FAX
E-mail   (required)
URL

Select the type service payment is applied toward:

Custom Software
Internet Web Service
Other  (Please explain in comment box below.)

Enter your Invoice #:     

Enter your PO #:     (If applicable)

Enter $ amount of payment (required & with decimal amt.)

Enter any special processing comments here:


Choose one of the payment methods: (Required)

Enter your Name as it appears on the card/check:(Required)

The following is for credit Card only:  


Enter your Card Number:


Enter your expiration date:

(required if using card)

 
The following is for Checking only:  


Enter your Bank Name:

Enter your Account #:

The first set of numbers from the bottom left

Enter your Routing Code:

The second set of numbers from the left.

Before submitting, please recheck that all information is correct. Thank you.