The Diamond Centre
2806 Ingersoll Avenue
Des Moines, IA 50312
Phone: (515) 279-9000
Email: info@diamondsmyway.com

Secure Payment Processing Terminal

 
Payment Summary:
Payment Date: 10/19/21
Payment Amount:
Service Fee (2.75%):
Total Charge:
Account Name or Account Number:
           
Credit Card Information:     
Card Type:

Name as on Card:
Card Billing Address:
Card Billing Zipcode:
Card Number:
Card Expiration Date: MMYY
Card ID (CVV2/CID) Number:
 [What is the Card ID?]
   
Customer Information:
First Name:
Last Name:
Address:
Address Line 2:
City:
State:
Zip:
Country:
Phone Number:
Email Address: