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Customer Payments by Credit Card

Pay one payment by Credit Card or set-up a monthly automatic payment charged to your Credit Card.
Payment requests received by 1:00PM Arizona time will be processed the next business day.
 Payment requests received after 1:00PM Arizona time, will be processed within 2 business days.
If you are close to the Cancellation Date,
call our office to make the payment, instead of using this form.




You can call in this information to 800-873-2732.

Customer Information

First Name  ( No ' or " )  
Last Name     ( No ' or " )
APFC Account Number      Your 8 digit account number
Address  
City, State, Zip   ,     
Main Telephone     212-555-6666
Secondary Telephone     212-555-6666
Email Address
 
  Used to notify you if Card is Declined
Social Security Number   555-12-3456

Credit Card Information
Credit Card  
Credit Card Number  
Expiration Date  mmyy  
CVV Code -  What is this?    
Credit Card Security Code (3 digits for Visa, MC or Discover)  (4 digits for American Express)
Name on Credit Card  
Credit Card Billing Address  
Credit Card Billing
City, State Zip
  ,             
     
Payment Options - select one option

Charge my Credit Card
One Time for the option selected below.
- there is a convenience fee of 3% for Visa, MasterCard or Discover and 5% for American Express per payment for this service, $5 minimum fee.

Set me up for Automatic Charge every month for the amount due
- there is a convenience fee of 3% for Visa, MasterCard or Discover and 5% for American Express per payment for this service, $5 minimum fee.
 
Select either payment option described above:

Select Number of Payments to Pay:  
Be sure to check the "I'm not a robot" box below before pressing submit

Press the Submit Button ONLY ONCE

You are submitting a REQUEST to process your credit card.  This is not a real-time transaction.
We will process the transaction and advise you by email, only if the transaction was declined.