Tulsa Adjustment Bureau
Secure Payment Form

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Payment Summary:
Date: 10/21/20
Amount(min. $25):
TAB Services Account No. or Last 4 of SSN:  
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?]
Email Address:
Phone Number: