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Cardholder Billing Information

Billing First Name
Billing Last Name
Phone Number
Email
Billing Street Address
Billing City
State/Province
ZIP/Postal

Tenant Information

Apartment Number

Bill Summary

Amount
Invoice Number
Description
Invoicing

Note: You may pay your rent online with Visa, MasterCard, or Discover. There is a convenience fee of 3% of the charged amount for all credit card transactions. There is no fee for E-Check transactions. Liberties Lofts, LLC does not share or sell customer personal information with any 3rd Party companies.

Payment Information

Card Number
Expiration Date (MMYY)
CVV
Bank Name
Name On Account
Account Type
Routing Number
Account Number
I agree to this fee and the terms and conditions of the payment.
Total amount with convenience fee: $0.00

 

Please fill in the required fields

I authorize to debit the bank account indicated in this web form for the noted amount on the schedule indicated. I understand that this authorization will remain in effect until the schedule end date, or until I cancel it in writing, whichever comes first, and I agree to notify the business in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the above noted payment date falls on a weekend or holiday, I understand that the payment may be executed on the next business day. I understand that because this is an electronic transaction, these funds may be withdrawn from my account each period as soon as the above noted transaction date. In the case of an ACH Transaction being rejected for Non-Sufficient Funds (NSF) I understand that the business may at its discretion attempt to process the charge again within 30 days, and agree to an additional $25 charge for each attempt returned NSF which will be initiated as a separate transaction from the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I will not dispute recurring billing with my bank so long as the transaction corresponds to the terms indicated in this agreement.
Privacy Information: None of your cardholder information or user information of any kind will be shared with any third-parties at all. Only the information that you enter on this form will be used to process your E-check or Credit-card transaction.