Abrams & Krochak Online Payment Facility

Information About the Credit Card Holder (i.e. Payor)

Cardholder Name

Address

City/Town

Province/State

Postal Code/Zip

Country

Telephone No.

Information About the Person on Whose Behalf Payment is Being Made (i.e. Client of Abrams & Krochak)

Relationship of Payor to Client (i.e. Self/Spouse or Partner/Parent/Sibling/Child/Friend/Employer/Other

(Please Specify)

Client First Name

Client Last Name

Client Residential Address

Client Mailing Address

(If it is not same as above)

Client City/Town

Client Province/State

Client Postal Code/Zip

Country

Client Telephone No.

Client Email

Abrams & Krochak Six Digit File Number
(If you are not yet a client of the firm, leave this section blank)

Reason for Remitting Payment

Provide details of the reason for payment

Payment Details:

PLEASE NOTE THAT WE ONLY ACCEPT CREDIT CARDS AND VISA DEBIT CARDS (see below for further instructions).

If you are paying Abrams & Krochak's legal fees with VISA, VISA Debit or MasterCard, please note that we accept payment in either U.S. or Canadian Dollars. If you are paying Abrams & Krochak's legal fees with American Express, please note that we accept payment only in Canadian Dollars.

If you were quoted legal fees in U.S. Dollars, but wish to pay in Canadian Dollars, please contact Abrams & Krochak and indicate that you wish to pay in Canadian Dollars to find out what amount in Canadian Dollars you should be remitting. Similarly, if you were quoted legal fees in Canadian Dollars, but wish to pay in U.S Dollars, please contact Abrams & Krochak and indicate that you wish to pay in U.S. Dollars to find out what amount in U.S. Dollars you should be remitting.

Type of Credit Card

Credit Card Number

CVV / CVD / CVC

CVV / CVD / CVC (For MasterCard, VISA and VISA Debit, this is a 3 digit number on the back of your card. For American Express, this is a 4 digit number on the front of the card.)

Expiry Date

Currency

CAD$

USD$

Amount

(i.e. 1600 - no dollar sign ($), abbreviations (CAD) or comma (,). Numbers only)