Hermitage Roofing Company
Card Type
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JAL
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Security Code
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Account Number
*
*
Routing Number
*
*
Check Number
(all fields required unless noted)
First Name
*
*
M.I.
Middle Initial
(optional)
Last Name
*
*
Address 1
*
*
Address 2
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City
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*
Zip Code
*
*
Phone
(for billing-related questions)
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Customer Number:
E-mail for Confirmation
E-mail Address
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Invoice/Ref #:
Service Fee:
Payment Amount:
*
*
Total w/Service Fee:
Surcharge:
Total w/Surcharge:
Service Fee Details
Card Present
Fee:
Total:
Card Not Present
Fee:
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Surcharge Notice
We impose a surcharge on credit cards that is not greater than our cost of acceptance. This surcharge rate is 3.00%. This surcharge is not applied on debit card or ach transactions.
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