By clicking "Enter Payment" located on this page and submitting a payment
through this system, I certify that I have Read, Understand and Agree to the following Terms and
Conditions and Privacy Policy.

I authorize Credit Service International to initiate a one-time charge/debit for this online
payment from the debit or credit account I designate under the terms of this authorization.
Credit Service International may make this charge/debit using a merchant debit/credit entry.
I ask that the financial institution that holds this debit/credit account to honor the charge
entry made by Credit Service International. I acknowledge that the origination of debit/credit
transactions to my account must comply with U.S. Law and the Rules of the Payment Card Industry
Data Security Standard (PCI DSS).

I understand that my authorized payment will be automatically debited/charged from this account on
this date. If a payment date falls on a weekend or holiday, the payment may be processed on the next
business day. If I have NOT selected a Transaction Date on the payment page, I am acknowledging that
my payment will be processed and charged/debited immediately. I acknowledge that card transactions
may be subject to a 3% processing fee as allowed by applicable state law. This fee is not applicable to
residents of the state of Washington.

For inquiries about this debit/credit transaction or my account, please contact Credit Service International
for further information. In the unlikely event your debit or credit payment is returned declined, we may
elect to electronically re-present your payment up to two more times. If the payment made is less than the
balance due on your account, the one-time payment will be processed, however, it will not constitute a
binding payment arrangement on your file. You must make arrangements with a Credit Service International
agent to confirm any formal payment arrangements.

Please note that if at any time you wish to revoke this authorization and cancel any scheduled recurring
debit/credit to your account, you must notify us by calling 866-844-2358 or 715-386-0424 during our normal
business hours of 9am to 5:30pm CST at least 3 business days prior to any scheduled debit date.