Payment Plan: Akers, Patrice
Card Number:
Expiration Month
Expiration Year
CVV 3-digit
Billing Street Address for Card
Billing ZIP for Card
Name on Card
*SIGNATURE: My typed name below constitutes my signature and agreement that my above Card may be auto-charged in the discounted amount of $2,902 on each of SATURDAY, January 31, 2026 and once again on SATURDAY, February, 7, 2026, for a grand total of TWO (2) payments:
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