Winston-Salem Branch
Secure Payment Form
Payment Summary:
Payment Date:
04/26/18
WFS Customer's Name:
Account Number or SSN:
Payment Amount:
Customer IP:
54.80.103.120
Debit Card Information (sorry, no credit cards):
Debit Card Type:
Visa
MasterCard
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?
]
Billing Information:
First Name:
Last Name:
Street Address:
Address Line 2:
City:
State:
Zip:
Country:
Phone Number:
Email Address:
Please allow 1 full business day for your payment to reflect on your WFS account.