THE BARN YARD
Secure Payment Form
Order Summary
Date
Requested Amount
Contract & Request Number
Salesman/Project Manager
Pay By Check
Pay By Credit Card
Name as on Check
Bank Routing Number
Bank Account Number
Bank Account Type
Checking
Savings
ACH Format
ACH Bank Payment
ACH
Billing Information
First Name
Last Name
Address
City
State
Zip
Phone Number
Email Address
Submit
