Jefferson Financial Services
Secure Payment Form

Your draft payment must be made by 3pm (EST) Monday-Friday in order to be credited to your loan the same day.
Note: Payments received after the due date and grace period will be assessed a late charge.

Order Summary:
Order Date: 05/23/22
Customer IP: 
Payment Amount:
Account Number:
Payment Description:
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?]
Billing Information:
First Name:
Last Name:
Address Line 2:
Phone Number:
Email Address: