Gloucester County
Secure Payment Form
Payment Summary
Government agencies cannot absorb customary credit or debit card fees. As a result the service fee covers the cost of processing the transaction.
Payment Amount
Service Fee (2.5%)
Total Amount
Dog Name
Contact Information
This information is used in the case that a payment cannot be matched to a license and to email a receipt.
Company Name
First Name
Last Name
Phone Number
Email Address
Credit Card Information
Name as on Card
Card Billing Address
Card Billing Zip
Card Number
Card Expiration Date
CVV2/CID
I authorize Gloucester County to initiate a single authorization to my card in the amount entered above, the acceptance of the 2.5% service fee, and that card transactions I authorize comply with all applicable laws. Payments made after 8:30 P.M Eastern time will be applied as of the next business day. To complete the payment process, click the “Submit” button. Once payment is authorized, there cannot be any changes or corrections. It is recommended that you print a copy of this authorization and maintain it for your records.