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Make a payment by credit card
OurRef
*
*
OurRef is located in bold in the subject line of our letter.
Also on the top right hand corner of the reverse of our letter.
Cardholder Name
A value for Cardholder Name is required.
*
Please enter your name as it appears on your credit card.
Card Number
A value for Card Number is required.
*
The 16 digit number that appears on the front of your card.
Expiry Date
01
02
03
04
05
06
07
08
09
10
11
12
Month
25
26
27
28
29
30
31
32
33
34
35
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37
38
39
Year
CSV
Payment Amount
A value for Entered Amount is required.
*
NB. Payment by credit / debit card will attract a variable merchant fee which will be displayed
here
once your card number is entered. This fee is the cost of acceptance charged to us by our
merchant facility provider. By proceeding with this transaction you hereby acknowledge and
accept that this fee will be added to the payment amount above.
Minimum payment is $20
Merchant Fee
*
Amount after fees
*
Notes
*
This field can be used to convey any pertinent message to ADR staff
in relation to your account.
Email To Receive Receipt
*
Phone
*
One-Off Payment
Recurring Payments
*
*
I hereby authorise the Merchant to debit my Card Account accordingly.
Please only press Proceed once as the Payment Amount will be processed once for each press.
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