SAMPLE ONLINE CHECK TRANSACTION

 

Internet Billing Company
Online Check

 

$19.95 for 30 days of access
 

Please fill in the form below to purchase your subscription by check. After your purchase is approved, you will be given instant access!
NOTE: Purchases can be made by the person(s) named on the Checking Account ONLY! 

US CHECKING ACCOUNTS ONLY!
 

Your IP address of 000.000.000.000 will be recorded with this transaction. All fraudulent transactions will be investigated and will be prosecuted. 
Enter all digits from left to right 
across the bottom of the check: 
Enter the check number at the 
top right-hand side of the SAME check: 
Email Address: 
(for example, james1701@aol.com) 
If you have used this Checking Account and Email Address with ibill before, you do not need to fill out the following information. You can simply press SUBMIT. 
Customer First Name: 
Customer Last Name: 
Date Of Birth:
MM  DD  YY  YY 
/  / 
Phone Number: (  ) 
Street Address Line 1: 
Street Address Line 2: 
City: 
State: 
Zip Code: 
Name of Person on Account: 

Please fill in the form above and click the
SUBMIT button. (only ONCE!)

Only press Submit ONCE
to avoid duplicate charges!

PLEASE BE PATIENT!
Authorization takes 2 minutes or more. If the server does not respond,
wait at least 5 minutes before resubmitting to avoid duplicate charges.

For your convenience your account will automatically be renewed,
unless you inform us otherwise.

Please contact Customer Service if you have any questions regarding this transaction.